The Right To Health

Context: Widening existing health inequities and catastrophic health expenditure has led to a rise in demand for Universal Health Coverage (UHC).

Initiatives for Recognising Health as a Human Right

• Global recognition:
  • The World Health Organisation’s (WHO) Constitution of 1946 envisaged the ideal of ensuring “the highest attainable standard of health as a fundamental right of every human being” by allocating the “maximum available resources”.
  • Global civil society coalitions: to make HIV treatment and sexual freedoms fundamental to human rights.
  • Inclusion in Sustainable Development Goals in 2015: for creating a legal obligation to ensure access to timely, acceptable and affordable quality healthcare.
• Public Health Law making in India: Recently, Rajasthan has introduce the Rajasthan Model of Public Health (RMPH) with following features-
  • Establishing and upgrading primary health centres.
  • Improving the delivery of services by expanding free medicines and diagnostics.
  • Inclusive health insurance programme with 50% subsidy for the non-poor sections (Rs 5 lakh worth of cashless) treatment cover for both inpatient and outpatient treatment.

Key Barriers to Universalising Health Coverage in India

• Non-recognition of Health as a Fundamental Right (FR) in the constitution: despite India being a signatory to the WHO.
• Low Public Health Spending (PHS): (1% against the global average of 8% ) results in high out-of-pocket expenditure - 62.67% (13th highest in the world).
  • PHS was 26.95% against the global average of 59.54%, with just 20 countries spending less than India in 2018.
• Positive partial correlation between income inequality and spending at all income levels.
• Failure of private Health: Increasing health spending or channelling it through private insurance and non-profit institutions is not sufficient for providing financial protection.
• Key barriers to the universalisation of healthcare:
  • Inadequate availability of services(in rural areas) and a severe shortage of human resources.
  • The rising cost of care due to the intensive use of technologies alongside changing perceptions of quality.

Way Forward

• Ensure universal access: to social determinants and primary healthcare services by focusing on malnutrition, access to toilets, safe water and basic health services.
• Improve primary healthcare infrastructure: in terms of buildings, human resources and technology.
• Rationalise use of limited resources: by doubling unavailable resources, reviewing interventions to remove waste and promoting efficiencies.