Healthy Budgeting for Healthcare

Context: Health Infrastructure Index (HII) (an index created by the authors) shows the vulnerability of a country to a pandemic.

About Health Infrastructure Index (HII)

• It ranks countries based on availability of physicians, dentists, nursing and midwifery personnel, pharmacists (infrastructure) etc. , all of which are normalised with respect to the population.
• HII accounts for variables such as money spent on account of healthcare activities by governments.
• India gets a lower rank —113th out of 184 countries.
• HII highlights critical areas where domestic or multilateral interventions are required.

Challenges to Healthcare Budgeting

• Infrastructural gaps: India’s healthcare system is not in great shape due to a dearth of hospital beds, doctors and paramedic staffs reacting to a health emergency like the Covid pandemic.
• Merely spending doesn’t necessarily lead to better outcomes:
  • For E.g. The US government spent almost double the amount on medical care compared to11 other wealthier nations.
  • However, compared to the 11 developed Organisation for Economic Cooperation and Development (OECD) countries, life expectancy is still lowest, and infant mortality rates still the highest in the US.
• Poverty and Inequality as a hurdle: Evidence suggests 5% of poor households residing in low-and middle- income countries spend disproportionately more than the rich on healthcare.
  • For a rich nation, like the US, life expectancy for the bottom 5% of poor people did not change between 2001 and 2014.
  • In Europe, the unmet need for medical care tended to be higher for disadvantaged in countries with larger income inequalities, regardless of average economic standard in terms of GDP per capita.

Need for compensation from the faulting countries:

• Demand for China to pay the price: China’s actions in combating Covid-19 are in violation of Article 6 and 7 of the International Health Regulation (IHR).
• To protect their economic and tourist activities, some countries such as Turkey, Indonesia and Russia have under-reported their Covid cases.
• Many governments are imposing sanitary and phytosanitary sanctions and an increase in the number of lawsuits, especially under Article11 of the World Trade Organisation dealing with quantitative restrictions.

Way Forward: Use of international arbitrations: International investment tribunals and other such bodies can be asked to review the states’ guidelines against the pandemic, thereby addressing many disputes.

• E.g. Peru has developed an online digital platform providing access to arbitration information.