Part of: GS Prelims and Mains III – Environment and Biodiversity; Conservation; Pollution; Government schemes and programmes; Governance issues
In news:
The NDA government has only finished 10 of the 100 sewage infrastructure projects commissioned after 2015 under the Namami Gange mission, according to records.
Nearly ₹23,000 crore has been sanctioned of the ₹28,000 crore outlay for sewage management work.
Commissioning of sewage treatment plants (STP) and laying sewer lines are at the heart of the mission to clean the Ganga. However, river-front development, cleaning ghats and removing trash from the river, which are just the cosmetic side of the mission make up about for ₹1,200 crore of the mission outlay.
Do you know?
The bulk of the projects completed were those commissioned before the Ganga mission began work in earnest under programmes such as the Ganga Action Plan-1and Ganga Action Plan-2, which began in 1987 and 1996 respectively.
Asia-Pacific to grow 5.7% this year: ADB
Part of: GS Prelims and Mains II and III – Economy; International Affairs
In news:
According to Asian Development Bank –
Asia-Pacific region is expected to power ahead growing at 5.7% this year
The bank’s lending grew to a record $21.6 billion in 2018, 10% higher compared to 2017.
Strategy 2030 plan of ADB
It focuses on six key areas –
operational and action plans for the private sector,
addressing remaining poverty and inequality,
accelerating progress in gender equality,
continuing to foster regional cooperation and integration,
expanding private sector operations and
using concessional resources effectively
(MAINS FOCUS)
HEALTH ISSUE
TOPIC: General studies 2
Issues relating to development and management of Social Sector/Services relating to Health.
Welfare schemes, mechanisms, laws, institutions and bodies constituted for the protection and betterment of these vulnerable sections
General Studies 3
Inclusive growth and issues arising from it
Why capping stent prices is no cure
Context:
Healthcare in India is in urgent need of a paradigm shift.
In the recent past, the sector has seen some significant policy announcements, with the government trying to finally make healthcare accessible and affordable.
Price capping of medical devices has been at the forefront of these announcements.
India heavily relies on medical device imports to meet its healthcare needs. Therefore capping of medical devices is an important policy announcement.
Benefits of capping stent prices:
Price control is necessary under the failed and exploitive market system characterised by exorbitant, irrational and restrictive trade margin.
India, in order to achieve its long-term goal of Universal Healthcare Coverage, it needs better equipment, skill development and policies that support medical innovations.
Price capping will minimise the expenditure in the health sector and allow more people to benefit from it.
Coronary artery disease (CAD) in India has become a major public health problem. (incidence of high morbidity and mortality). Therefore, price cap on coronary stents have helped a larger number of patients from lower-income groups undergo life-saving angioplasty since their number went up sharply after the price-regulation move.
It also allows transparency and better government control and audit ease.
Why capping stent prices is no cure?
India is still battling healthcare challenges like availability of adequate infrastructure, trained professionals, rapidly changing disease burden and catastrophic out-of-pocket expenses. (Needs comprehensive reforms in other areas too)
The medical device market in India is under-penetrated, and access to quality and affordable medical service remains a challenge.
For instance, there has been a drastic fall in the Foreign Direct Investment (FDI) in the medical device sector (according to recent reports). Drug-eluting stents are mostly manufactured by medical-device MNCs and after capping stent price many have either pulled out their state-of-the-art stents from the Indian market or have announced plans to do so.
Now, at this point, where India imports 70% of its medical devices, the industry is dependent on the global community for the inflow of technology and innovation.
While the domestic industry finds its feet in this market, the access of these devices to patients cannot be paused.
If a high-quality stent by a global manufacturer becomes inaccessible to the patients, it can have severe implications on the health of millions.
Do you know?
The capping slashed the price of drug-eluting stents by as much as 70%.
Top-rung MNCs pulling their products out of the Indian market also has serious implications for patients in the country.
Conclusion:
Well-considered price control is a positive step, but more needs to be done. Government is progressing towards increasing access and adoption, improving quality, and lowering healthcare delivery costs in the country.
However, healthcare policies are not about what serves the short-term purpose, but what works for the people in the long run.
Critics argue that subsidising stents at public hospitals based on income could have been better alternative in order to solve the problem of lower-income patients, who are more likely to opt out of life-saving procedures because of high stent costs.
The lack of pricing freedom in medical devices sends out signals to the international investing community that regulatory action in India could be a potential threat.
Connecting the dots:
Indian healthcare framework needs a comprehensive regulatory framework that goes beyond price control. Other key elements of healthcare- insurance coverage, healthcare infrastructure etc.- must be stressed upon. Analyze.
Without pharmaceuticals’ market reform, Universal Healthcare Coverage will be a distant dream. Elucidate.
The recent measure of price control on medical devices is seen as anti-market practice. Critically discuss the need for such measures in a welfare state like India. Will it inhibit innovation in the field? Justify.
ECONOMY
TOPIC: General studies 2 and 3
Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
Indian Economy and issues relating to planning, mobilization of resources, growth, development and employment.
Inclusive growth and issues arising from it.
For a simpler GST
Introduction:
The collections from the Goods and Services Tax (GST) in April for economic activity in March scaled a new high.
The GST inflows of ₹1,13,865 crore in April are the highest recorded since the tax regime was introduced in July 2017.
This is the second consecutive month of GST mop-up topping Rs 1 lakh crore-mark and 10 per cent higher than Rs 1.03 lakh crore collected in April 2018.
However, the unorganised sectors, especially the small traders and producers, are the ones facing adverse impacts.
The large and medium-scale producers who are expected to benefit the most from GST are confused since hundreds of changes have been announced from the time it was launched.
Even chartered accountants and lawyers who are to help businesses cope with GST are often left befuddled.
More and more cases are being filed in courts due to lack of clarity and varying interpretations.
Do you know?
The government suspended the more difficult parts of the GST provisions — like e-way bill, GSTR2 form — for a while.
Government recently raised the limit for registration under GST from Rs 20 lakh to Rs 40 lakh and for the composition scheme from Rs75 lakh to Rs 1.5 crore to exempt most small businesses.
Many tax rates have been brought down. But the problems persist because they are structural and not just a result of poor implementation.
The way ahead:
The proponents of GST believe that the problems are temporary and that structural changes take time to give dividends. GST is the biggest reform in India, no matter what the difficulties, they maintain that eventually all will be well.
GST needs a structural change with effective implementation.
In order to encourage greater compliance, there must be efforts to make it easier for small firms to remain in the tax net by cutting down the time and energy required to fill myriad tax returns.
Connecting the dots:
How will GST impact the economy of India in short term. Critically analyse.
Do you think the present GST tariff structure addresses the generally regressive nature of indirect taxes? Critically examine.
Enumerate the salient features of proposed new GST law. Discuss the challenges to be faced due to GST implementation.
