Curbing individualism in public health

Source– The post is based on the article “Curbing individualism in public health” published in The Hindu on 13th December 2022.

Syllabus: GS2- Issues related to development and management of health

Relevance: Public Healthcare System

News- The article explains the need to prioritise society oriented population-based approaches over individual-oriented interventions for public health.

What is the recent example related to it?

The Pradhan Mantri Jan Arogya Yojana (PMJAY) under Ayushman Bharat is the largest health insurance scheme in the country. It covers hospitalisation expenses for a family for ₹5 lakh a year. The entire scheme doesn’t talk about the need for hospitalisation services per year for any population.

Instead, every individual is given an assurance that if there is a need for hospitalisation expenses and the scheme will cover the expenses.

What are the facts associated with it?

Data from the National Sample Survey Organisation (75th round) show that on an average, only 3% of the total population in India had an episode of hospitalisation in a year.

The assurance of a service remains an unfulfilled promise when more than 90% of those who were given the promise do not need hospitalisation in the near future.

In case of COVID-19, It was also evident that around 20% of the total COVID-19 positive cases needed medical attention, with around 5% needing hospitalisation and around 1%-2% needing intensive care (ICU) or ventilator support.

Most of the deaths due to COVID-19 are a reflection of the failure to offer ventilator and ICU support services to the 1%-2% in desperate need of it. The morbidity profile of a population across age groups is an important criterion used to plan the curative care needs of a population.

What it means is that for population-level planning, the need of the population as a single unit needs to be considered.

What are the reasons for the dominance of individualism in public health?

The first is the dominance of biomedical knowledge and philosophy in the field of public health. It leads to the misconception that what is done at an individual level, when done at a population level, becomes public health.

The visibility of health impacts among the general public is a big reason. Health effects are more visible and appear convincing at the individual level.

the market’s role and the effect of consumerism in public health influence the choices of people. The beneficiaries for a programme become the maximum when 100% of the population is targeted.

What is the way forward?

All forms of individualistic approaches in public health need to be resisted to safeguard its original principles of practice, population, prevention, and social justice.