May this new year bring health to India, wealth to its healthcare budget and wisdom to its lawmakers. This is the essence of a charter demanding rational, ethical and universal healthcare for Indians released by an alliance of doctors. The group also makes an important connection. Perhaps realizing that legislative will to bring change in this country is inextricably linked with political gains, they have called on political parties to incorporate the charter into their 2019 election manifestos. Most of the demands are not new — take, for instance, the one about improving India’s low public spending on healthcare. The share of the healthcare sector in the budget has remained way below even a measly two per cent for over a decade; the indifference that the doctors are trying to remedy is thus not unique to one political dispensation. Another agenda is that the government should cap trade margins for medical devices at 30 per cent, which is 35 per cent lower than the last recommendation by the Niti Aayog. But would such a capping be enough? India has no regulatory body for medical devices, their sale, promotion or adverse outcomes; this makes the market ripe for corruption. There are other serious gaps that the doctors shed light on such as the provision of free medicines and diagnostics at all public hospitals, proper implementation — the lack of which stymies most measures in India — of the Clinical Establishments Act, the marketing of medicines under generic names only and so on.

The most important observation that the medical professionals make, however, is regarding the Ayushman Bharat scheme — the so-called largest government-funded healthcare project in the world. A meagre budgetary allocation is, once again, a problem; the sum insured per person is far from enough to cover even the most basic medical procedures. But the reason why the critique of this project assumes significance is that the doctors use it to differentiate between healthcare and health coverage. Insurance for procedures when a person is already sick is not a substitute for regular healthcare. Indeed, most of India’s healthcare initiatives take a curative approach instead of aiming for preventive care. The latter would require the lawmakers to join the dots between healthcare and other welfare initiatives like women and child nutrition and sanitation. The doctors have taken the first step by outlining the lapses that keep India’s public healthcare from being truly for the people and put the onus of making it so on the ruling class. It is now up to people to keep up the pressure to get what is their fundamental right.