By Madiya Mushtaq
Health care is an essential aspect of human well-being, yet its accessibility and quality remain uneven across the globe. The right to health care is enshrined in various international treaties and national constitutions, but the realization of this right faces significant legal, economic, and social challenges. As we navigate the complexities of modern society, it is imperative to critically examine the legal frameworks surrounding health care and the obstacles that impede its universal provision.
- Legal Perspectives on the Right to Health Care
The right to health care is recognized as a fundamental human right in numerous international documents. The Universal Declaration of Human Rights (UDHR) of 1948 explicitly states in Article 25 that “everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including… medical care.” Similarly, the International Covenant on Economic, Social and Cultural Rights (ICESCR) of 1966 emphasizes the right of everyone to “the enjoyment of the highest attainable standard of physical and mental health.”
National constitutions and legal systems also reflect this commitment to health care rights. For instance, the Constitution of India, under Article 21, has been interpreted by the Supreme Court to include the right to health as an integral part of the right to life. Likewise, the Affordable Care Act (ACA) in the United States marked a significant step toward ensuring broader access to health care services.
Despite these legal recognitions, the practical implementation of the right to health care varies significantly. Wealthier nations often have more robust health care systems and legal protections in place, whereas developing countries struggle with limited resources and infrastructure. This disparity highlights the importance of not only recognizing health care as a right but also ensuring that legal frameworks are effectively implemented and enforced.
- The Right to Health: Definition and Origins
The right to health refers to the most attainable levels of health that every human being is entitled to. This right is fundamental to human dignity and encompasses access to timely, acceptable, and affordable health care of appropriate quality. The origin of the right to health dates back to 1946 with the establishment of the World Health Organization (WHO), the first international organization to formulate health as a human right.
- Governmental Responsibility
The right to health is an essential component of human dignity, and it is the responsibility of governments to ensure that this right is protected and promoted for all individuals, regardless of their gender, race, ethnicity, religion, or socioeconomic status. In India, the Directive Principles of State Policy (DPSP) under Part IV of the Constitution ensure social and economic justice, directly or indirectly relating to public health policy.
- Related Provisions in India
- International Conventions: India is a signatory to Article 25 of the Universal Declaration of Human Rights (1948), which grants the right to a standard of living adequate for health and well-being, including food, clothing, housing, and medical care.
- Fundamental Rights: Article 21 of the Constitution of India guarantees a fundamental right to life and personal liberty. The right to health is inherent to a life with dignity.
- DPSP: Articles 38, 39, 42, 43, and 47 place an obligation on the state to ensure the effective realization of the right to health.
- Judicial Pronouncements: The Supreme Court of India, in cases such as Paschim Banga Khet Mazdoor Samity (1996) and Parmanand Katara vs. Union of India (1989), has reinforced the government’s duty to provide adequate medical facilities and the professional obligation of doctors to protect life.
- Significance of the Right to Health
- Rights-Based Healthcare Services: Recognizing the right to health compels governments to take steps to provide comprehensive health services.
- Wide Access to Health Services: It ensures everyone can access high-quality health services, improving overall public health.
- Reduced Out-of-Pocket Expenditure: Protects individuals from the financial burdens of medical costs, reducing the risk of poverty due to health expenses.
- Challenges Related to the Right to Health in India
- Inadequate Healthcare Infrastructure: Despite improvements, India’s healthcare infrastructure remains inadequate, especially in rural areas. With only 1.4 beds per 1,000 people and 1 doctor per 1,445 people, the majority of the population lacks basic medical facilities.
- High Disease Burden: India faces a high burden of communicable and non-communicable diseases, requiring significant investment in healthcare infrastructure and resources. More than 33% of individuals suffer from infectious diseases, with high out-of-pocket expenditure.
- Gender Disparities: Women in India face significant health disparities, including limited access to healthcare, higher rates of maternal mortality, and gender-based violence. They account for fewer hospital visits than men for critical services.
- Limited Health Financing: With only 2.1% of GDP spent on healthcare in FY23, India’s public spending on health is much lower than the average for lower- and middle-income countries, leading to inadequate healthcare services.
- Improving the health care system in India: Strategies and Solutions:
India, with its vast and diverse population, faces significant challenges in delivering adequate health care to all its citizens. Despite various initiatives and reforms, the health care system still struggles with issues such as inadequate infrastructure, inequitable access, and a high burden of disease. To transform the health care landscape and ensure universal health coverage, a multifaceted approach is required. Here are several strategies and solutions to improve the health care system in India.
1. Increasing Public Health Care Spending
Current Scenario: India’s public spending on health care is around 2.1% of GDP, significantly lower than the average of lower- and middle-income countries.
Solution: The government needs to increase its health care budget to at least 5% of GDP. This additional funding can be used to build new health care facilities, upgrade existing ones, and purchase essential medical equipment. Enhanced financial investment is crucial for expanding infrastructure and improving the quality of care.
2. Strengthening Primary Health Care
Current Scenario: Primary health care facilities are often underfunded and understaffed, particularly in rural areas.
Solution: Strengthening primary health care involves establishing well-equipped and adequately staffed health and wellness centers across the country. Training and retaining a sufficient number of primary health care workers is essential. Additionally, integrating digital health solutions like telemedicine can extend the reach of primary health services, especially in remote areas.
3. Enhancing Health Care Infrastructure
Current Scenario: India has 1.4 hospital beds per 1,000 people and 1 doctor per 1,445 people, with a significant concentration of health care facilities in urban areas.
Solution: To address this disparity, the government should focus on building and upgrading hospitals in rural and underserved areas. Investing in mobile health clinics and telehealth services can also help bridge the gap in health care access. Ensuring a more even distribution of health care facilities will make health services accessible to the broader population.
4. Improving Health Care Workforce
Current Scenario: There is a shortage of trained health care professionals, with many preferring to work in urban areas or abroad.
Solution: To tackle this issue, the government should increase investment in medical education and training programs. Incentivizing health care professionals to work in rural and underserved areas through better pay, housing, and working conditions can help address the workforce gap. Continuous professional development programs can ensure that health care workers are up-to-date with the latest medical practices and technologies.
5. Ensuring Affordable and Quality Health Care
Current Scenario: High out-of-pocket expenditure on health care services is a significant burden for many families.
Solution: Implementing universal health coverage (UHC) schemes such as Ayushman Bharat is a step in the right direction. The government should further strengthen these schemes to cover more services and reach a larger population. Additionally, regulating the private health sector to ensure affordability and quality of care is necessary. Establishing price caps on essential drugs and procedures can help control costs.
6. Promoting Preventive Health Care
Current Scenario: The focus on curative care often overshadows preventive health measures.
Solution: Investing in preventive health care through public health campaigns, vaccinations, and regular health screenings can reduce the overall disease burden. Encouraging healthy lifestyles through awareness programs on nutrition, physical activity, and the dangers of smoking and alcohol can lead to a healthier population and lower health care costs in the long run.
7. Leveraging Technology and Innovation
Current Scenario: There is a growing adoption of technology in health care, but it remains limited in scope and reach.
Solution: Expanding the use of digital health technologies such as electronic health records (EHRs), telemedicine, and mobile health applications can improve health care delivery and patient outcomes. Implementing robust health information systems can facilitate better data collection, analysis, and decision-making. Encouraging innovation in health care through public-private partnerships can lead to the development of cost-effective and scalable solutions.
8. Enhancing Health Care Governance and Accountability
Current Scenario: There are issues related to corruption, inefficiency, and lack of accountability in the health care system.
Solution: Strengthening governance and accountability through transparent policies and robust regulatory frameworks is essential. Establishing independent bodies to monitor health care delivery and address grievances can enhance accountability. Implementing performance-based incentives for health care providers can improve efficiency and service quality.
9. Addressing Social Determinants of Health
Current Scenario: Factors such as poverty, education, and living conditions significantly impact health outcomes.
Solution: A holistic approach to health care must address social determinants of health. Improving education, ensuring access to clean water and sanitation, and providing social security measures can create an environment conducive to better health. Multi-sectoral collaboration between health, education, housing, and other relevant sectors is crucial for addressing these determinants.
10. Engaging Communities and Strengthening Public Health Programs
Current Scenario: Community engagement in health programs is often limited.
Solution: Actively involving communities in health care planning and implementation can lead to more effective and sustainable health programs. Strengthening public health programs such as the National Health Mission (NHM) can ensure that essential health services reach the grassroots level. Empowering community health workers and promoting community-based health insurance schemes can further enhance health care access and equity.
Improving India’s health care system requires a comprehensive approach that addresses both systemic and specific challenges. By increasing public health care spending, strengthening primary health care, enhancing infrastructure, and improving the health care workforce, India can move towards achieving universal health coverage. Ensuring affordable and quality health care, promoting preventive health measures, leveraging technology, enhancing governance, addressing social determinants of health, and engaging communities are crucial steps in this direction. With sustained efforts and strategic reforms, India can build a health care system that is accessible, equitable, and capable of meeting the needs of its diverse population.
Views expressed in the article are the author’s own and do not necessarily represent the editorial stance of Kashmir Observer
- The author is an Advocate, Supreme Court of India
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