State insurance schemes have failed the poor: Report

Our Bureau New Delhi | Updated on June 24, 2019

The report flagged the total failure of Central and State health insurance schemes in providing financial protection to the poor   -  STR

Researchers point to sharp divergence in economic prosperity and social development

A comprehensive analysis of the social impact of rising inequality released on Monday by former Prime Minister Manmohan Singh has blamed State policies for catastrophes like the outbreak of Acute Encephalitis Syndrome (AES) that has resulted in 120-plus deaths in Bihar.

The India Social Development Report-2018: Rising Inequalities in Indiahas 22 different papers in seven sections.

It has been edited by former Chairperson of the Commission for Agricultural Costs and Prices T Haque and former Dean of the School of Social Sciences D Narasimha Reddy, and published on behalf of the Council for Social Development (CSD) by the Oxford University Press.

The report was released and discussed by the former PM and scholars, including former Delhi University Vice-Chancellor Deepak Nayyar; former Planning Commission member Abhijit Sen; former Deputy Director-General, WTO, Harsha Vardhan Singh; and President, CSD Muchkund Dubey.

Uneven growth

The report, focussing on “multidimensional inequality” in India, presented a Social Development Index (SDI) by synthesising about six dimensions and 28 indicators.

These included not just access to health, education, labour, inter-regional and rural-urban inequality but also wage data, areas of residence and social groups.

A significant conclusion presented by the SDI was that the States that are economically progressive are not necessarily the ones with top ranks in social development.

“Kerala, Mizoram, Himachal Pradesh, Jammu and Kashmir and Meghalaya are examples of lopsided social development, featuring high social development and low per capita income,”said the report.

“Uttar Pradesh and Haryana are featured with lopsided growth marked by high per capita income and low social development,” it added.

Health expenditure

A critical failure was highlighted in the areas of health and education.

K Srinath Reddy, former head of the Department of Cardiology at the All India Institute of Medical Sciences and President of the Public Health Foundation of India, in his paper titled Can India’s New National Health Policy Bridge the Disconnect with Development, made a critical revelation about the total failure of Central and State health insurance schemes in providing financial protection to the poor.

“Of great concern has been the finding that these Central and State insurance schemes have failed to provide financial protection to those who sought care,” Reddy said in his paper.

“There was no demonstrated benefit when measured by any of the three indicators of financial protection for heath care — no reduction in the ‘out-of-pocket expenditure’ on health, no reduction in the catastrophic health expenditure and no reduction in health-care related impoverishment,” added Reddy.

These observations come at a time when the Bihar government’s own survey of the encephalitis patients in Muzaffarpur district has shown that two-thirds of the patients belong to Below Poverty Line (BPL) families.

Rural literacy

A paper by Muchkund Dubey on Universalising Quality School Education in India made a strong case for a publicly-funded common school system.

The 2011 Socio-Economic and Caste Census has revealed that close 36 per cent of rural Indians were illiterate and another 14 per had less than primary level of education.

“If we add to this those having completed only the primary level without reaching the middle level, we get a figure of an additional 18 per cent. Thus, 68 per cent, or more than two-thirds of rural India, had no or low education on the eve of the second decade of the 21st century,” said Dubey.

Published on June 24, 2019

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