Healthcare as a Social Service

Healthcare as a Social Service recognizes that access to medical care is a fundamental right and a societal responsibility. Its constitutional basis lies in Article 47 of the Directive Principles of State Policy, which directs the state to improve public health. Article 21 (Right to Life) is also relevant.

The key provisions include:

• •Ensuring equitable access to healthcare services for all citizens.
• •Focus on preventive healthcare and health promotion.
• •Strengthening public health infrastructure, especially in rural areas.
• •Addressing social determinants of health, such as poverty, sanitation, and education.
• •Promoting affordable healthcare through government subsidies and insurance schemes.

In practice, it involves government-funded healthcare programs, public hospitals, and subsidized medical care. Schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aim to provide health insurance coverage to poor families. The government also focuses on strengthening primary healthcare through Health and Wellness Centres (HWCs).

Challenges include:

• •Inadequate public health infrastructure, especially in rural areas.
• •Shortage of healthcare professionals.
• •Lack of awareness about health and hygiene.
• •High out-of-pocket expenditure on healthcare.
• •Inequitable access to quality healthcare services.

It improves the overall health and productivity of the population, reduces poverty by decreasing healthcare costs for vulnerable populations, and contributes to human capital development. A healthy workforce is more productive, leading to economic growth.

Suggested reforms include:

• •Increasing government investment in healthcare to reach 2.5% of GDP.
• •Strengthening primary healthcare infrastructure.
• •Improving the quality of healthcare services.
• •Promoting digital health initiatives.
• •Addressing social determinants of health through inter-sectoral coordination.

Article 21 (Right to Life) and Article 47 (Directive Principles of State Policy) are the most important articles.

Initially rooted in the Directive Principles of State Policy, it has evolved with various National Health Policies and schemes like AB-PMJAY. The focus has shifted towards universal health coverage and strengthening primary healthcare.

Healthcare as a Social Service emphasizes equitable access and affordability for all, while Healthcare as a Commodity treats medical care as a market product, where access depends on the ability to pay. The former prioritizes public health, the latter prioritizes profit.

While many developed countries have universal healthcare systems funded through taxation, India's approach is a mix of public and private healthcare, with a focus on providing subsidized care to vulnerable populations through schemes like AB-PMJAY. India is still striving towards universal health coverage.

A common misconception is that it implies free healthcare for all, which is not always the case. It primarily focuses on ensuring equitable access and affordability, often through subsidized or insured care.

The future likely involves increased government investment, strengthened primary healthcare, greater use of technology, and a continued focus on achieving universal health coverage. The National Health Policy (2017) provides a roadmap for this.