IASbaba’s Daily Current Affairs – 18th April, 2016
NATIONAL
TOPIC: General studies 2
Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes; mechanisms, laws, institutions and Bodies constituted for the protection and betterment of these vulnerable sections.
Issues relating to development and management of Social Sector or Services relating to Health, Education, Human Resources.
A case of public health in India
Those at the helm of policymaking in the country have been, for some time, strongly advocating austerity as the principle for public expenditure policies, particularly for the social sectors.
The extent of austerity in health sector:
Arvind Panagariya, the vice-chairperson of the NITI Aayog, suggests that “for just three-quarters of a per cent of the GDP”, 0.76 per cent to be precise, “the government can provide at least a modest healthcare cover for the bottom half of the population” after which “there does not remain a case for additionally free provision of the service by the government”.
A keen look at the budget allocations for the health sector:
The projected 13 per cent increase of total allocation on health for 2016-17 over previous year’s spending of 33,841 crore amounts to a nominal increase by Rs.4,365 crore.
Using CPI-IW as deflator and assuming that inflation will stay at this year’s rate of 5.9 per cent, an estimate in real terms projects an erosion of 2,000 crore. So, in real terms, the increase in 2016-17 amounts to a mere 6.6 per cent.
This is especially meagre if we consider the fact that last year’s health expenditure (revised estimates) had declined in real terms from actual spending of 2014-15.
In proportion to GDP, this year’s total allocation on health has reduced to 0.254 per cent compared to actual spending of 0.256 per cent in 2014-15.
Gradual weakening of the National Health Mission (NHM):
One of the major concerns in the health sector of India is the gradual weakening of the National Health Mission (NHM) whose main components are public health care infrastructure other than tertiary care, programmes for prevention of communicable diseases like TB, vector-borne diseases, etc.
The share of NHM in total health budget has been gradually reduced during the last three years from 56.2 per cent in 2014-15 to 54.1 per cent in 2015-16 to this year’s allocation of 49.8 per cent.
What does the budget focus on then?
Another significant reduction is in Family Welfare Scheme whose allocation this year is less than half of 2015-16 expenditures or less than one-third of expenditures in 2014-15.
The budget is primarily for promoting, procuring and distributing contraceptives and other materials and for information, education and communication (IEC).
A tilt towards tertiary health care:
It is evident from the tragic deaths of women in Bilaspur sterilisation camp in November 2015 (in a private set-up), that the IEC without infrastructure and welfare services means nothing.
The maternal health and welfare component of family has been given just a mere representation. Thus, instead of welfare, the budget is tuned to population control!
Medical care institutions, primarily in the tertiary care sector, see a boost of 18 per cent over 2015-16 at the cost of primary and secondary healthcare institutions.
The majority of the population lags in access at that level.
What this policy programming indicates is that while the majority of the population has been left to its own devices, the state has become a protector of the medico-industrial complex catering only to the rich.
Neglect of allied sectors:
People’s health is dependent upon allocation of allied sectors such as food subsidy and ICDS, and these have declined in real terms.
Water and sanitation, which had faced significant budget cuts in 2015-16, have been allocated just the amount incurred as expenditure for 2014-15 in real terms.
Allocation in MGNREGS, an important scheme to boost rural employment and wages, has also declined in real terms from the revised estimates of expenditure for 2015-16, even without considering the Rs.6,000-crore pending payments.
As a percentage of GDP, allocation in food subsidy, MGNREGS and ICDS have declined compared to 2015-16 and 2014-15, while that of water and sanitation have reduced vis-à-vis 2014-15.
Way ahead:
Mere reallocation of resources from the primary care sector to the tertiary with paltry health coverage for a small section of the population through health insurance is grossly inadequate.
The substance of the latest Budget for health is that it promotes not universal health coverage but the medical care market.
Connecting the dots:
What do you understand by universal health coverage? Explain the measures taken by the government to achieve universal health coverage in India.
To what extent National Health Mission can be used as a tool for promoting better public health in India. Substantiate.
For Detailed Analysis ‘Healthcare issues & challenges’ refer the below links-
Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
Issues with Urban Governance
Outcomes of weak governance—
Horrific flooding in Chennai in 2015,
Delhi’s newly acquired status as the world’s most polluted city,
Mumbai’s forever-potted roads
The eye-popping rise in the number of rape cases from 165 to 643
Cases of molestation rose from 483 to 1,675 over the last four years
What constitutes weak urban governance?
Weak urban governance refers to institutional defragmentation, whereby multiple agencies often have overlapping roles, are run by officials who are not accountable to citizens, and the absence of a single individual accountable to the polity.
Whose city is it?
Mayors are deemed accountable for cities but in spirit it is the chief minister. Cities are controlled by armies of bureaucrats and the chief minister, while the world’s major cities, like London, New York, Paris, and Shanghai, are all run by powerful mayors
Urban areas are not large enough for them to determine the fate of a general election which ultimately leads to lack of focus on urban governance reforms.
Urban dwellers are not sufficiently represented in the sanctums of decision-making. Delimitation, that is, allotment of the number of seats in the House of the People (Lok Sabha) to the states, and the total number of existing seats in the Legislative Assemblies was last done on the basis of Census 1971. According to the 84th and 87th Constitutional Amendments, this allocation will only be altered based on the first Census after 2026 (Blocks focus + funds)
The economic might of cities makes them appealing to the political classes thereby increasing their tendency to continue enjoying the significant leverage that can be traded to raise funds which, in turn, are used to fight elections in rural India.
The lack of human resource capacity in the country spanning the political class, the intelligentsia, the bureaucracy and the private sector proves to be the main reason for the slow pace of reform
Eg: The ongoing debate on the Goods and Services Tax (GST) Bill— designed to create a harmonized tax structure by subsuming several local body taxes, like the entertainment tax, advertisement tax, entry tax, and luxury tax. If passed, the urban local bodies (ULBs) will lose their own source revenue streams without adequate legal provisions in place to mandate steady compensation.
The 10 Point Urban Reform Programme—
Reform the 74th Constitutional Amendment to empower city governments, bolster the metropolitan system of government, and move to a system of a directly elected mayor.
Fix governance at the Centre and in the states to reduce fragmentation and facilitate alignment of functions.
Make the office of the mayor politically relevant to create a culture of meritocracy and performance.
Build world-class institutions to catalyse capacity at scale.
Establish a National Urban Finance Corporation of India to fund urban infrastructure projects.
Set up the regulatory architecture required to facilitate efficient and effective urban services delivery.
Reform the civil service, and establish executive agencies to hollow out inefficiencies.
Revitalize the role of the State Finance Commissions to bolster municipal finances.
Introduce state-specific laws on land use and transport to override legislative vacuum.
Deepen citizen engagement in cities to drive change across localities.
Connecting the Dots:
Is India following an incrementalist approach towards urban governance? Critically examine.
NITI Aayog takes steps to foster cooperative federalism- Officials said though the Aayog is in news for big reports and recommendations, it has quietly managed to get some fundamental changes done in the states
RCEP negotiations: India likely to take a more aggressive stand- Commerce ministry estimates that signing the agreement will lead to a revenue loss of as much as 1.6% of gross domestic product
Should bank defaulters’ list be made public?- Tarring all defaulters and bankers with the same brush will choke the flow of funds to business, scare bankers and kill entrepreneurship
New law, statutory body imperative to foster fair trade practices in India- Frequent stories of big brands indulging in false advertising should be no surprise, as there is no law to check it
