IASbaba's Daily Current Affairs Analysis

IAS UPSC Prelims and Mains Exam – 07th February 2019

(PRELIMS + MAINS FOCUS)

Sabarimala Row: Faith versus Equality

Part of: GS Prelims and Mains II – Fundamental Rights; Fundamental Duties; Role of Judiciary

In news:

A total of 65 petitions challenged the authority of the court to intervene in a centuries-old belief that the Sabarimala deity is a ‘Naishtika Brahmachari’, whose penance should not be disturbed by the entry of women worshippers of the menstruating age of 10-50.

Some advocates who fought the odds to enter the temple premises said –

It was the fundamental duty of citizens under Article 51A (h) of the Constitution to “develop scientific temper, humanism, spirit of enquiry and reform.” That is what the Supreme Court judgment urges citizens to do.
Restrictions on women based on biological factors is discriminatory and as a result violates Articles 14 (right to equality), 15 (prohibition of discrimination), 17 (untouchability), and cannot be protected by “morality” based on Articles 25 (freedom to practice and propagation of religion), 26 (Freedom to manage religious affairs).
Article 25 (1) mandates freedom of conscience and right to practice religion. “All persons are equally entitled to freedom of conscience and the right freely to profess, practise and propagate religion…”

However, the Nair Service Society sought a review of the verdict on the ground that the exclusion was not based on gender or sex, but on religious faith in and character of the deity.

The temple’s chief priest argued that “every devotee has a fundamental right to worship in a temple in a manner which is in sync with the character of the deity.” He further said – “In Hindu religion, God is worshipped in different manifestations…Devotees have to worship in sync with the characteristics of that manifestation to attain salvation.”

Pic: https://d39gegkjaqduz9.cloudfront.net/TH/2019/02/07/DEL/Delhi/TH/5_01/6b034d69_2716726_101_mr.jpg

Panel defers resort project at Andamans

Part of: GS Prelims and Mains III – Development versus Environment; Biodiversity; Conservation

In news:

An expert committee of the Union Environment Ministry has “deferred” clearance to a ₹100 crore proposal by the Andaman and Nicobar Islands Integrated Development Corporation Limited (ANIIDCL).
The project was expected to develop an island resort, as well as put up “premium tents” and “tree houses”.
Clearance was not issued on the grounds that it doesn’t take into account the biodiversity of the islands’ coast.

Do you know?

Home Ministry revived an Island Development Agency that would coordinate infrastructure projects to aid tourism in the A&N islands as well as Lakshadweep.
The Centre has been working on a long-term plan to make several of the islands more conducive to tourism.

Centre bans Kashmir outfit

Part of: GS Mains III – Security issues

In news:

The Union Home Ministry has banned the Tehreek-ul-Mujahideen (TuM) under the Unlawful Activities (Prevention) Act for promoting terrorism and radicalising and recruiting youth for terrorist activities in India.
According to the Minsitry, TuM (which was set up in the 1990s) claims to be fighting for the “liberation of Kashmir”.
The TuM carried out a number of terrorist attacks besides subversive acts, namely grenade attacks, weapons snatching incidents, supporting other terrorist outfits such as Hizb-ul-Mujahideen (HuM), Lashkar-e-Taiba (LeT), etc. in terms of financial and logistic support in the recent past.

Pic: https://d39gegkjaqduz9.cloudfront.net/TH/2019/02/07/DEL/Delhi/TH/5_11/299f015b_2716771_101_mr.jpg

Do you know?

Last year, eight TuM men were killed in various operations by security forces. Mostly, well-educated and belonging to urban settlements.

India’s communication satellite GSAT-31 launched successfully

In news:

India’s latest communication satellite, GSAT-31 was successfully launched from the Spaceport in French Guiana.
GSAT-31 has a unique configuration of providing flexible frequency segments and flexible coverage. The satellite will provide communication services to Indian mainland and islands.
GSAT-31 will provide DTH Television Services, connectivity to VSATs for ATM, Stock-exchange, Digital Satellite News Gathering (DSNG) and e-governance applications. The satellite will also be used for bulk data transfer for a host of emerging telecommunication applications.

Pic: https://d39gegkjaqduz9.cloudfront.net/TH/2019/02/07/CNI/Chennai/TH/5_11/25a32f4b_75b479d2_101_mr.jpg

(MAINS FOCUS)

NATIONAL/HEALTH ISSUE

TOPIC: General studies 2

Issues relating to development and management of Social Sector/Services relating to Health

Development processes and the development industry the role of NGOs, SHGs, various groups and associations, donors, charities, institutional and other stakeholders

India needs a leap in healthcare spending

Concerns in Health Sector:

Poor public health spending

Government aims to increase public health spending to 5% of GDP. However, current health spending is only 1.15-1.5% of GDP.
To reach its target, the government should increase funding for health by 20-25% every year for the next five years or more.

Poor allocation in Interim Budget

The recent Interim Budget failed to adequately respond to the needs of the health sector.
The total allocation to healthcare is ₹61,398 crore (an increase of ₹7,000 crore from the previous Budget). However, there is no net increase since the total amount is 2.2% of the Budget, the same as the previous Budget.
The increase roughly equates the ₹6,400 crore allocated for implementation of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY).

Per capita spending on health

Public per capita expenditure on health increased from ₹621 in 2009-10 to ₹1,112 in 2015-16.
Per capita spending on health for 2018 is approx. ₹1,500.
Despite the doubling of per capita expenditure on health over six years, the public spending figure is still abysmal.

Comparison between two large democracies

U.S.’s health expenditure is 18% of GDP, while India’s is still under 1.5%.
In U.S. allocation for healthcare is 23.5% of the Budget. Per capita spending on health in the Budget is $3,150.
In India, allocation for healthcare is merely 2.2% of the Budget. Per capita spending on health in the Budget in India is approx $30.
$4,000-$5,000 per capita spending in OECD countries.
Per capita Budget expenditure on health in India is among the lowest in the world. This requires immediate attention.

High out-of-pocket expenditure

Out-of-pocket expenditure in India is at a massive 67%.
The ₹6,400 crore allocation to Ayushman Bharat-PMJAY in the Interim Budget will help reduce out-of-pocket expenditure on health.

The way ahead:

Increase the public health spending by 20-25% every year for the next five years or more.
Increase the per capita Budget expenditure on health.
Set up more health and wellness centres
Health and wellness centres should focus not only on preventive health, screening, and community-based management of basic health problems. It should also include health education and holistic wellness integrating modern medicine with traditional Indian medicine.
Policies should focus on long-term commitment and resource allocation.
NITI Aayog has proposed higher taxes on tobacco, alcohol and unhealthy food in order to revamp the public and preventive health system.
A focused approach in adding tax on tobacco and alcohol, to fund non-communicable disease prevention strategies at health and wellness centres, should be considered.

Do you know?

₹250 crore has been allocated for setting up health and wellness centres under the National Urban Health Mission. Under the National Rural Health Mission, ₹1,350 crore has been allocated for the same.
Nearly 1.5 lakh health and wellness centres would be set up under Ayushman Bharat.
The non-communicable diseases programme of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Strokehas been allocated ₹175 crore, from ₹275 crore.
Allocation to the National Tobacco Control Programme and Drug De-addiction Programme is only ₹65 crore, a decrease of ₹2 crore.

Conclusion:

Increase of GDP alone does not guarantee health, since there is no direct correlation between GDP and health outcomes.
However, improvement in health does relate positively to GDP, since a healthy workforce contributes to productivity.
PMJAY must be linked to quality and health sector must be made a priority area, like defence.
Only if we invest more for the long-term health of the nation will there be a similar rise in GDP.

Connecting the dots:

Can increase in scope of private financing to fund public health care be a rational option? Evaluate.
What do you understand by universal health coverage? Explain the measures taken by the government to achieve universal health coverage in India.

POLITY/HEALTH ISSUE

TOPIC: General studies 2

Issues relating to development and management of Social Sector/Services relating to Health

Development processes and the development industry the role of NGOs, SHGs, various groups and associations, donors, charities, institutional and other stakeholders

Centre-State Relations; Functions and responsibilities of the Union and the States, issues and challenges pertaining to the federal structure, devolution of powers and finances up to local levels and challenges therein.

Will Ayushman Bharat hurt the spirit of cooperative federalism?

Context:

We know that –

Prime Minister had rolled out the centre’s flagship Ayushman Bharat
The scheme includes National Health Protection Scheme renamed as Pradhan Mantri Jan Aarogya Yojna (PMJAY) and Health and Wellness Centres (HWCs).
The scheme will also subsume two ongoing centrally sponsored health insurance schemes namely Rashtriya Swasthya Bima Yojna (RSBY) and the Senior Citizen Insurance Scheme (SCHIS)

About Ayushman Bharat

It is an integrated approach covering primary, secondary and tertiary healthcare through – access to Health and Wellness centres (HWCs) at the primary healthcare level and financial protection for accessing curative care at the secondary and tertiary levels through PMJAY.
Ayushman Bharat is assumed to be giant leap towards providing accessible and affordable health care to the common man.
With PMJAY, the government is taking healthcare protection to a new aspirational level. This would be the world’s largest government funded healthcare program targeting more than 50 crore beneficiaries.

Against the spirit of cooperative federalism?

However, some states – West Bengal, Telangana, Delhi and Odisha – have not joined Ayushman Bharat. Therefore, the question arises whether the scheme is hurting the idea of cooperative federalism.

1. Health is State Subject – Since, the Seventh Schedule of the Constitution makes States responsible for hospital services, the States have their own schemes to provide financial risk protection to those seeking medical relief.

The constitution endows upon the state government autonomous powers. They are directly elected by the people of their respective states and are voted to power on certain promises.

2. Entire credit to the current administration – The insistence to prefix Ayushman Bharat to existing State names and the despatch of a personalised letter to 7.5 crore families with only the Prime Minister’s photograph were seen as attempts to attribute the entire credit to the current administration, though State governments are equal partners — funding 40% of the scheme, bearing the responsibility of its implementation and covering double the number of beneficiaries.

3. Creating of National Health Authority (NHA) – NHA to provide standardised procedures, costs, build an institutional architecture and access all data for effective monitoring. This standardisation can stifle innovation and entail costly structures that may not accommodate local conditions, preferences, and cost-effective solutions.

4. Some of the State Schemes are better than Ayushman Bharath – For instance, Punjab’s Bhagat Puran Singh Sehat Bima Yojna (BPSSBY) scheme covers 29.3 BPL families whereas Ayushman Bharat covers only 14.96.

Telangana’s Arogyashri and Odisha’s BSKY is already a step ahead of the Ayushman Bharat Scheme.

Odhisa has a unique PPP project called Affordable Healthcare Project (AHP). Under this project, the state is encouraging private participation not only in providing healthcare but also in building requisite infrastructure by way of providing viability gap funding. The scheme, Biju Swasthya Kalyan Yojana (BSKY), is touted to be an improved version of what Ayushman Bharat is. It covers more people with a higher cover.

The AAP government is critical of the scheme because they believe it has been launched without adequate budgetary support or other means of resource mobilization. Moreover there has not been commensurate focus on developing requisite infrastructure to make the scheme of this scale work.

Conclusion:

Providing more funds to the States, subject to achieving certain goals, would have provided more scope to innovate, model the design to fit their context, resource base, epidemiological status, level of development, take total ownership and be accountable for outcomes.

Only when the federal constituents are given freedom to accept or reject proposal by the central government, democracy gets its nutrition and prospers in a sustainable way.

Connecting the dots:

Will Ayushman Bharat hurt the spirit of cooperative federalism? Critically examine.

(TEST YOUR KNOWLEDGE)

Model questions: (You can now post your answers in comment section)

Note:

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Q.1) Consider the following about centre’s flagship Ayushman Bharat scheme:

The scheme includes National Health Protection Scheme renamed as Pradhan Mantri Jan Aarogya Yojna (PMJAY) and Health and Wellness Centres (HWCs).
The scheme will also subsume two ongoing centrally sponsored health insurance schemes namely Rashtriya Swasthya Bima Yojna (RSBY) and the Senior Citizen Insurance Scheme (SCHIS)

Which of the statements given above is/are correct?

1 only
2 only
Both
None

Q.2) Consider the following statements about National Health Protection Scheme

It covers 10 crore poor and vulnerable families
It is a flagship programme under Ayushman Bharat
It will provide coverage upto Rs 5 lakh per family per annum in secondary and tertiary care institutions

Select the correct statements