People's Democracy

Editorial

Sixty Years of the Founding of Indian Republic

People's Democracy  greets its readers on the occasion of India's 61^st Republic Day.  We join the rest of India in celebrating the completion of sixty years of the founding of our Republic. 

All ancient civilisations consider the completion of 60 years � Sashtipoorti -  very auspicious. This signifies the resolve for continuing to live healthily. The quality of life, thus, assumes greater importance than longevity.   It is, therefore, an appropriate occasion to assess the  health of our nation measured by the quality of life of our people. 

In the customary address to the nation on the eve of the Republic Day, the president of India has called for a `second Green Revolution' to ensure food availability to the people ensuring food security.  This is also  required to avoid the spiraling of the food prices.  The president called for positive action and some `out of the box thinking' by the government on this score.  On the same day, inaugurating the Diamond Jubilee celebrations of the Election Commission of India, the president called upon the country to make democracy `cleaner, healthier and stronger'.  Amongst all required reforms to make our democratic system stronger,  the health of the nation assumes an important bearing  determining the quality of democracy in our country.  It is, therefore, only appropriate that we evaluate  the health of our nation as reflected in the quality of life of our people. 

Tragically, this has to begin on an ominous note.  A Planning Commission study completed in May 2009 on the basis of surveys conducted in several villages showed that health care expenses were responsible for more than half of all people declining into poverty.  On the basis of the National Sample Survey Organisation's (NSSO) data for 2004-05 (unfortunately, the latest year for which such data is available), it is estimated that an additional 39 million people were pushed into poverty due to health care expenses in that year alone. 

During these years of neo-liberal economic reforms, alongwith all other public services, health care in our country has been increasingly privatised. While public spending on health care has been around a measly 1 per cent of the GDP, private spending has grown alarmingly to 4.2 per cent of GDP.  It is estimated that more than 70 per cent of entire health expenditure in India is borne by the people from their own resources.  With galloping privatisation of health care during the last five years, such expenditures have been rising especially for the poor and the marginalised sections of our people.  Further, the NSSO data shows that over 80 per cent of health care expenditures is on purchase of drugs.  It is common knowledge that the drug prices have been  rising exponentially in recent years. Meaning, larger numbers must be sliding into poverty.

Based on data for 2007, the UN Human Development Report has shown, amongst others, a decline in India's per capita income over the previous year. It has also shown a decline in life expectancy at birth and in the gross enrollment ratio in schools.  47 per cent of our children are underweight due to malnutrition and nearly 17 per cent having a probability at birth of not reaching the age of 40.  It is estimated that nearly 75.6 per cent of our people live on less than $ 2 a day.  Adjusting this in purchasing power parity terms, we come very close to the estimation made by the prime minister  appointed committee, headed by Arjun Sengupta,  that 77 per cent of Indians survive on Rs 20 a day. 

The liberalisation pundits often scoff at such  data and argue that faster the economy grows, the faster would be the reduction in poverty.  The prime minister himself, recently,  has been very defensive about this logic and was on his back foot expressing grave concern at the insignificant reduction of poverty levels.

The myth of a stronger economy and a faster growth rate leading automatically to better health for its people has been exploded, once again.  The current pre-occupation of President Obama for his new health care policy was based on the fact that nearly 16 per cent of the US population has no  coverage of health insurance.  One half  of all personal bankruptcies  in the USA have been due to medical expenses.  Though the US Congress and the Senate have finally approved two separate legislations (facing tough resistance by lobbies of vested interests), they now need to be combined and approved as a single proposal before the president can sign it into law. 

Despite spending nearly a fifth of its huge national income on health care (huge profit avenues for private capital and insurance companies), USA's overall  health indicators are worse than neighbouring socialist Cuba which has a one-twentieth per capita income.  Between 1955 and 2008, Cuba increased its life expectancy from 53 to 79 years while  in the US, it went up from 69 to 78 years.  Both in terms of child mortality and infant mortality, Cuba fared  better than the USA.  In fact, Cuba's per capita daily calorie intake is marginally higher than in the US!

This can only be understood by capitalism's inexorable  drive, more pronounced under globalisation, to reduce all public utilities into commodities  in the pursuit of its raison d'etre - profit maximisation. Capitalism has little need for commodities like health, education, sanitation etc which have an irreplaceable `use value' determining the quality of life of human beings.  Capitalism needs to convert these `use values' into commodities with `exchange values'  that generate profit. 

Thus, growth per se  does not guarantee better health for its people.  Reliance on private capital to provide health care can never improve the situation for the vast majority as such investments pursue profit maximisation, not social benefit.  What is required is a political will and a social commitment to vastly enhance public expenditures in health care. If this UPA-2 government is serious about heeding the advise of president of India to undertake `out of the box thinking', then this is the course that it should adopt.  This is the only way in which we can vastly improve  the health of our people thereby the health of our nation and its democracy. 

Public pressure through popular mobilisations must be brought about to force the government to adopt such a course in the interests of our country and people.  This is the only way that India, for the sake of its people, must  celebrate its Sashtipoorti.