SONGSOPTOK
INTERVIEW WITH SOUMYA
HEALTHCARE – A
RIGHT OR A PRIVILEGE?
SONGSOPTOK: Do you consider primary healthcare
to be a fundamental right? Is it deemed as such in the society you live in?
Please explain your answer with a few examples if possible.
SOUMYA: Primary healthcare
should be considered as a fundamental right. Having said that, I feel that in a
country like India even fundamental rights are flagrantly violated, and primary
healthcare has every chance of being neglected even if it comes to be treated
as a fundamental right. As of now, healthcare is not a fundamental right in
India, and primary healthcare more so.
SONGSOPTOK: What is the
system of healthcare in the country and the society you live in? Is it a just
and equitable system in the sense that all citizens enjoy the same benefits
across economic and social classes?
SOUMYA: Healthcare in India and the immediate society I live in is not
at all equitable, where the poor suffer poor health and the very poor suffer appallingly. In addition the gap
in access to healthcare between the rich and poor remains very wide. There is
also a dominant urban-rural gap in the availability of medical services. The
facilities available with the government institutions are inadequate and suffer
from dearth of funds, poor management, political and bureaucratic interference,
lack of leadership in medical community, etc. India ranks very low in any objective international ranking of
countries by health status. Despite the advances made in the tertiary sector in
the development of several large multi-speciality commercial hospitals, and
also in the provision of a decent level of primary healthcare in a few States
such as Kerala and Tamil Nadu, health deprivation on a mass scale stands out as
one of the country’s intractable challenges.
SONGSOPTOK: Do you think that free healthcare cannot be a right, but
it can be a privilege and a shared burden of sacrifice for the sake of the
social contract?
SOUMYA: I feel ideally healthcare for the masses, particularly for the economically
underprivileged, should be the responsibility of the government. The sense of
‘a shared burden of sacrifice’, in my opinion is not a tenet that would either
be understandable in this country or appreciated across the body polity. For India the system that is best likely to
work is a directed mandatory contribution to the healthcare corpus in exchange
of certain articulated benefits, in which system the contribution would vary
according to the individual earnings.
SONGSOPTOK: What, in your opinion, should be the role of the
government for ensuring equal healthcare to all citizens? What role is played
by the government of the country you live in?
SOUMYA: In India, where healthcare remains the most potent domain for
securing business, equal healthcare to all citizens is something which is
beyond the scope of the government – a choice willingly accepted by the
government. What the government can and should do is to ensure affordable
healthcare to the economically underprivileged sections of the society and to
assume a role of leadership in reducing the impact of endemic diseases across
the country since only the government has the proper mechanism to administer
and lead such efforts.
SONGSOPTOK: According to the data published by World Health Organization
(WHO), nearly 16 000 children under the age of 5 die every day in the world
(5.9 million in 2015) from infectious, neonatal or nutritional conditions. Is
this a reality in the country you live in? If so, what would your suggestions
of improvement be?
SOUMYA: Since independence there has been considerable improvement in
provision of neonatal care in the country, though the effort is woefully
inadequate as of now. I feel that a large component of government intervention
should be directed to child and geriatric care. Nutrition is yet another source
of worry for India, as the larger section of the underprivileged population
still do not have access to two square meals a day.
SONGSOPTOK: “Free access to healthcare is a fundamental human right.
Access to free healthcare is not” – do you agree with this statement? Please
explain your choice.
SOUMYA: I agree to the statement
SONGSOPTOK: How important is the role of the private sector for
providing healthcare and related facilities in your country? What it is your
opinion about it?
SOUMYA: The private sector is already relevant in India in so far as
healthcare for the affluent is concerned. However, private healthcare providers
view healthcare as a business opportunity rather than from an altruistic point
of view and in my opinion these service providers would have little or no
interest in mass healthcare interventions.
SONGSOPTOK: Are charitable and Non-Governmental Organizations (NGO)
active in the domain of public health? If yes, then in what spheres? Do you
think that the civil society, either independently or through these
organizations, should become the prime actor for ensuring healthcare for all?
SOUMYA: Many charitable and NGOs are active in the provision of
healthcare to the masses, but there is a lot of overlap in the individual
efforts. A parallel model can definitely be conceived whereby the willing
organizations working in close collaboration with civil society can take care
of certain identified and niche healthcare areas.
SONGSOPTOK: Do you think that multinational pharmaceutical and
healthcare companies are responsible, to a certain extent, for the widely
variable quality of healthcare in different countries? Can you please
illustrate your reply with some examples?
SOUMYA: Pharmaceutical companies, in my opinion, are the biggest
culprits for the poor state of healthcare that exists in many developed and
developing countries. These companies have immense clout and almost a
throttlehold on individual government in so far drug pricing practices are
concerned. In addition, these companies in my opinion reduce the population in
poorer countries to human guinea pigs and conduct clinical trials which they
can do in their own countries at a hefty price. Many of the sufferings in the
poorer countries are results of the drug dumping practices followed by the
pharmaceutical companies. The nexus between pharmaceutical companies – government
–private healthcare providers are also quite visible.
SONGSOPTOK: Do you think that adopting the Social Security model
implemented in a lot of countries in Europe which ensures primary health
coverage to all citizens and is financed by the totality of the working
population can be relevant and efficient in all countries?
SOUMYA: This system in my opinion is an elegant model where the working
population in its totality finances healthcare for all in a specific country.
But whether this model can be relevant in India is doubtful, given the huge
population of the country and the wide gap that exists between individual
earnings.
SOUMYA SEN SHARMA: Senior Principal Scientist, CSIR-CMERI,
Durgapur, India. Electical Engineer from Jadavpur University, Soumya is
specialized in Electrical Motors and Renewable Energy Systems. Group Head
at CMERI, he has worked for several projects linking renewable energy and
sustainable development. He is involved in various societal projects both in
professional and personal capacity
We sincerely thank you
for your time and hope we shall have your continued support.
Aparajita
Sen
(Editor:
Songsoptok)
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