IASbhai Daily Editorial Hunt | 24th Nov 2020
“If there is no struggle, there is no progress.” – Frederick Douglass
EDITORIAL HUNT #258 :“COVID-19 and Public Health Expenditure | UPSC”
Pulapre Balakrishnan | Sreenath K Namboodhiry
COVID-19 and Public Health Expenditure | UPSC
Pulapre Balakrishnan is Professor of Economics, Ashoka University and Sreenath K Namboodhiry is Academic Associate, Indian Institute of Management, Kozhikode
Some of the COVID-19 mortality was avoidable
In India, the varying death rate across States during the pandemic points to the neglect of health in public policy
SYLLABUS COVERED: GS 3 : Diseases
Economic policy that prioritises growth and a substantial investment in health sector can ease the revival of Indian Economy post COVID-19 . Discuss -(GS 3)
- Public expenditure on Health sector
- Importance of Funding
- Case Study : North East India
- THE NEW NORMALS : Eight months into the COVID-19 epidemic, there is an understandable longing for a return to normalcy in our everyday lives.
- THE OLD NORMALS : However, there is one area in which we cannot afford to return to the old normal and that is the attention paid, actually the lack of it, to health in public policy.
- IGNORANCE IS FATAL : We are by now in a position to at least tentatively quantify how much its neglect has cost us in the past eight months.
PUBLIC EXPENDITURE ON HEALTH
- VARIATIONS IN MORTALITY RATES : Repeated reference to the relatively low death rate in India compared to parts of the Americas has meant overlooking the wide variation in the death rate across the States of India.
- INCOME LEVELS AND DEATHS : It is found that far from income contributing to the prevention of death from COVID-19, States with a higher per capita income often had higher death rates.
VARIATION IN DEATH RATE ACROSS INDIA
- HEALTH INFRASTRUCTURE : Data suggest that it is the level of public expenditure on health.
- EXPENDITURE ON HEALTH : There is high variation among India’s States in the public expenditure on health as a share of the domestic product, and the death rate is negatively related to it.
- DENSITY VS AGE PROFILE : This fatality rate has a possible impact of the age profile of the population and its density.
SOURCES : STATISTA
FUNDING IS IMPORTANT
- SAVING EACH LIFE : Actually, during an epidemic, much needs to be done beyond treating patients in intensive care units at the final stage of the disease.
- IDEAL RESPONSE TO PANDEMIC : Now, an effective combination of medical expertise, protocols and management practices becomes central to the effectiveness of the response to an epidemic.
- APPROPRIATE FUNDS : Sufficient funding is what enables this to occur within the short span afforded by a health emergency.-WHO
- INCOME BIAS : The data in India allows us to at least take a view on whether some deaths may have been prevented even at the income level that we have.
GROWTH OVER HEALTH
- VULNERABLE POPULATION : When this computation is done, We can find approximately 72% of the 1.25 lakh deaths that had occurred till November 7 could have been saved.
- APPROXIMATIONS CAN ALTER : It is possible that the State with the median health expenditure has some unique characteristics that reduce the death rate from COVID-19.
- DEVOLUTION OF FUNDS : The State-wise pattern of public expenditure on health is inversely related to the per capita income of the States.
- MISMATCHED FUNDING : The health spend of the richer States in relation to their domestic product is lower than that of the poorer States.
- IGNORING HOSPITAL BEDS : So the neglect of health in public policy can be termed a choice made by these States.They prioritised economic growth over the health of their populations.
SOURCES : ECONOMIC TIMES
THE EXAMPLE OF THE NORTHEAST
- NORTH EASTERN STATES : North-eastern India has registered much lower death rates than the rest of the country.
- POPULAR CLAIMS : This pattern has led to speculation on the innate characteristics of the population of this region and claims of its lower exposure to the virus.
- INFECTED POPULATION : Actually the percentage of the population infected in the northeastern States is not much lower than that in the rest of the country.
THE GOVERNANCE CHALLENGE
- AIR POLLUTION : Even once the COVID-19 virus has become less deadly, we are likely to continue to suffer from air pollution, a medically recognised threat to life.
- HAZARDOUS POLLUTION IN AIR : Air pollution in Delhi is caused by a combination of stubble burning in the neighbouring States and rampant construction activity, motor vehicles and garbage burning within its own territory.
- NEW POLICY INITIATIVES : It has actually been suggested that public funds be used to pay farmers to stop burning their stubble.
- ENVIRONMENTAL ECONOMICS : This would not just be a reversal of the commonly accepted principle in environmental economics that ‘the polluter pays’ but untenable from the ethical standpoint.
- DEATH RATE VS PUBLIC HEALTH EXPENDITURE : There is much less between the death rate and medical infrastructure in the public sector, be it hospitals or hospital beds per person.
“It is doctors who treat patients, not hospital beds”
Economic policy that prioritises growth, even by default, can lead to environmental damage, and a political process without ethical awareness cannot confront it at its source.
SOURCES: THE HINDU EDITORIAL HUNT | COVID-19 and Public Health Expenditure | UPSC