Some time back, US President-elect Joe Biden has announced a USD 1.9 trillion coronavirus relief package to tackle the economic fallout from the pandemic, including direct financial aid to average Americans, support to businesses and to provide a boost to the national vaccination programme. It includes USD 415 billion focused on combating the COVID-19 pandemic, over USD 1 trillion in direct aid to individuals and families and USD 440 billion in assistance to businesses. It includes USD 1,400 in additional stimulus cheques to Americans, an extension for key unemployment programmes from mid-March to the end of September and an increase in weekly additional unemployment assistance from USD 300 to USD 400 and increasing the federal minimum wage to USD 15 an hour over time.[1].
Yesterday the RBI had announced some relief measures for the business and banking sector. However the need of the hour is to announce a Billion dollar ( 70 thousand Lakh Rupee) package towards infrastructure , Businesses and direct payments to the unemployed, farmers and weaker sections of the society. If you think that is too high then we are sorry to say that you have not understood the magnitude of the corona crisis, the credibility and confidence crisis prevailing in the country. Moreover the Medical infrastructure the nation requires would need something gigantic and not just miniscule amounts. A part of this should also be spent on boosting the business and employment environment in the country and direct money transfer to the needy.
One of the major complaints and grievances the country had and genuinely so was the falling medical infra in the country. People complained why the Modi government has not dedicated attention on improving medical facilities in the country. It is common sense that when there is panic, rationality takes a back room and one can hear all sort of nuisance and rumors floating in the air.
Our country began with a glorious tradition of public health, as seen in the references to the descriptions of the Indus valley civilization (5500–1300 BCE) which mention “Arogya” as reflecting “holistic well-being. The Chinese traveler Fa-Hien (tr.AD 399–414) takes this further, commenting on the excellent facilities for curative care at the time. Today, we are a country of 1,296,667,068 people (estimated as of this writing) who present an enormous diversity, and therefore, an enormous challenge to the healthcare delivery system. This brings into sharp focus the WHO theme of 2018, which calls for “Universal Health Coverage-Everyone, Everywhere.” [2]
The country has been almost stagnant in terms of medical infrastructure in the country for almost 70 years. The first break came when the NDA government announced setting up additional AIIMS in the country. The Modi government announced a number of schemes and also wellness centers in the country. India under the leadership of Prime Minister Modi has set the ball rolling to build a robust health care ecosystem in the country. The world’s largest healthcare scheme – Ayushman Bharat, is the first step in that direction. The flagship programme covers hospital costs up to Rs. 500,000 for the poorest 40 per cent of Indians. COVID19 can be an opportunity for the government to strengthen the social healthcare scheme in the country. The scheme aims to cover more than 500 million beneficiaries and provide coverage of Rs. 500,000 per family, per year.
However they all are like drop in the vast ocean of Indian population. WE have one of the lowest medical infrastructure in the country. If we wish to look at China, then it is way ahead in terms of medical facilities.
As per a Fitch report, with 8.5 hospital beds per 10,000 population and 8 physicians per 10,000, the country’s healthcare sector is not equipped for such a major crisis. Moreover, the significant inefficiency, dysfunctioning and acute shortage of the healthcare delivery systems in the public sector do not match up with the growing needs of the population. The most recent government statistics show, India spent only 1.28 per cent of its GDP on health in 2017-18, compared to nearly 18 per cent in the United States, and far lower than neighbouring countries, including Indonesia (1.4 per cent) and Sri Lanka (1.68 per cent).
India has 1154686 registered doctors in the speciality of modern medicine. At present a single Government Allopathic Doctor caters to the need of 10926 persons. Currently, 60% of the total of India’s population lives in rural India. To provide healthcare facilities to the people living in rural India, the government has established 25743 Primary Health Centers, 158417 Sub Centers, and 5624 Community Health Centers [11]. Currently, 713986 beds are available in government hospitals in India which amounts to 0.55 beds per 1000 population.
The current situation indicates that there is going to be an imbalance between demand and availability of hospital beds, ICU beds, ventilators, PPE, and trained medical personals throughout the country. If we consider that only 0.1% of the total population gets infected in the next 2 months and only 5% among them need ICU beds, then we will be needing 65000 ICU beds.[3]
Besides the need of hospitals and beds then there is the additional burden of having Oxygen generators, ventilators and to develop a complete Eco system that can make the country self sufficient.
Conclusion:
All these woul;d require enormous Medical iNfra fund. The government also has to push for boosting business sentiments and help the weaker section, farmers and other street vendors who are unable to help themselves through direct money transfer. Arvind Kejriwal must be congratulated that he has announced Rs 5000 to auto rickshaw wallas and others thus boosting his image as messiah of Poor. The Jaganath Reddy govt has announced free hospital facilities for covid patients where the medical bills will be absorbed by the state governments. Such popular schemes and announcements boosts public confidence and trust in the government. The Modi government too has to announce a few such big schemes starting with a medical infra fund and a Billion dollar package. Nothing else will suffice to calm down public sentiments.
References:
[1] https://www.thehindu.com/news/international/biden-announces-usd-19-trillion-covid-19-stimulus-plan-to-revive-us-economy/article33577301.ece
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166510/
[3] https://www.clinmedjournals.org/articles/iaphcm/international-archives-of-public-health-and-community-medicine-iaphcm-4-041.php?jid=iaphcm
Asheesh Shah
Samanvaya.
