[Answered]Bringing public health under concurrent list and declaring health as a fundamental right can improve India’s healthcare system. Discuss.

The Lancet in its latest study ranked India at 145^th among 195 countries in terms of quality and accessibility of healthcare, behind its neighbours China, Bangladesh, Sri Lanka and Bhutan. Recently, a high level group has recommended the 15th finance commission to bring health under concurrent list and declaring health as a fundamental right.

Need of bringing public health under concurrent list:

1. Low healthcare spending: India’s government spends only 1% of GDP (Gross Domestic Product) on health (Ministry of Health and Family Welfare), of which 80% is raised and spent by the states themselves. Achieving a public health expenditure of 2.5 % can be done by bringing health under concurrent list.
2. Indigenous practices: States do minimum to preserve indigenous healthcare systems and practices. Bringing health under concurrent list would allow Centre to spend in a better way to preserve indigenous systems of medicine, like Ayurveda.
3. Cooperative federalism: Health Under concurrent list will further the spirit of cooperative federalism. State-level Policy implementation regarding the health sector has underperformed and is plagued by poor quality and corruption. With health as a part of the concurrent list, the government can ensure a better healthcare system by working with states in a better way.
4. Better policy implementation: With health under concurrent list, the central and state governments would find a way to collaboratively design better policies and better implementation of union government initiatives. For example, a health scheme launched by the centre is implemented by states and funded by them makes its implementation poor.

Importance of declaring health as a fundamental right:

1. Social justice: A fundamental right is justiciable. Once health is made a fundamental right the citizens can approach the courts for its violation. It can prevent poor from being denied basic health services on basis of various factors like race, religion, caste etc.
2. Unaffordable health system: The large number of people still living below the poverty line in India. Thus the affordability of quality healthcare is a problem and needs to be addressed.
3. Discrimination: Cultural differences such as social, cultural, and linguistic barriers may prevent patients from accessing care. E.g. minorities may face discrimination in accessing quality health services.
4. Increasing risks: Environmental challenges, which include unsafe streets, asthma exacerbated by air pollution, leading to unnecessary hospitalisation and minimal or no spaces for physical activity or exercise all add to risk to health of millions of poor.

With an objective to achieve Universal Health Coverage by 2030, the Government of India has initiated significant reforms to improve citizens’ access to good quality, affordable healthcare. There remains, however, a need to strengthen the broad ecosystem in which health services are delivered. For this, public health under concurrent list and declaring health as a fundamental right can help India’s health system. This will result in eventually achieving larger health objectives.