I refer to the presentation ‘Save public health care’ (1). Health is described as a ‘fundamental human right’, hence it is averred that the government must provide health care to the citizen.
The same argument could be extended to food, another basic need. The right to food evolves from the constitutional right to life. Yet the state does not ensure free food even to the ‘poorest of the poor’. In the absence of food security for the impoverished, demand for free health care is a mix-up of priorities. For that matter, what percentage of the population has access to safe drinking water — which is jeevan or life itself? Moreover, contaminated water is the source of most diseases in India.
The Brihanmumbai Municipal Corporation (BMC), on the other hand, cannot satisfactorily fulfil even the obligatory duties of providing sanitation, water supply, maintenance of roads and footpaths, and primary civic amenities. Health care and education are discretionary functions of the BMC which the state government should undertake to provide as a welfare measure.
It is an idealistic situation where medical services would be free for the indigent. But who foots the bill? The BSES which distributes electricity to Mumbai’s suburbs says its relatively high tariff for energy is because the company is obliged to service the massive slum population. A subsidy to one section of the population becomes a levy on another. Would an economically middle-class citizen be categorised as ‘affluent’ just because s/he pays taxes to the government and local body?
Unlike charity, social security is a right of all citizens in a welfare state. And the state subsists on taxes, hopefully levied equitably.
There is degeneration in any subsidised service, which in real economic terms is perceived as ‘free’. A classic example is municipal school and undergraduate education. Public hospitals, despite their professional competence, have acquired an unfavourable reputation. With a burgeoning migrant population, this reputation will slide down even further. On another plane, witness the rights to livelihood and shelter being operated by the hawkers and slum dwellers in Mumbai; the latter alongside railway tracks are now accused, by none other than the Supreme Court, of pickpocketing, for demanding free housing.
Today food is ‘available’ in plenty but it is ‘non-affordable’ to the poor and deprived. It is the same story of lack of economic access to health care. Population and unemployment graphs are inversely related. Shouldn’t population control be the first priority if a welfare state is to succeed? Emotions and economics don’t blend.