I am writing this note after listening to the finance minister’s speech which was accompanied by the thumping of the ruling party on the floor. After listening to the very carefully crafted rhetoric that was put before the citizenry, I (as a citizen of this country) want to present my position vis – a – vis the much-emphasized spending on health. The section on health was presented as if the health system of India needed a pandemic to recognise the importance of budgetary allocation on the spending on health care. It was a magical act indeed to summarily dismiss the work of the Bhore committee in 1946 and subsequent committees who were given the task of recommending on health-related policies of the country and who have continuously provided a roadmap towards building the necessary tangible and intangible health care infrastructure of the country. This year’s union budget boasted about the increase in the spending of health by around 135% as compared to the previous year’s allocation. When the finance minister said that the spending on health has been increased by 135%, there was no effort to blanket the lie that this year the announcement of the health expenditure includes a large proportion on water and sanitation (Jal Jeevan Mission) and Covid – 19 Vaccine. The vague timeline of 5 – 6 years is another important indicator that ensures ‘maximum government and minimum governance’ in terms of fixing accountability and tangibility to these numbers.
The budget speech by the Finance Minister was a modest attempt at objectively dealing with the countries curative health system, often relying on the role of private sector and no mention as to how the allocation would strengthen the already existing health centres/infrastructure on the ground. In the last three months, many farmers have died due to the cold (preventive ailment) that they got exposed to while sitting to improve the ‘nation’s health’ – by putting a barricade against the farm laws. Does making policies in silos do well? The programme of Poshan Abhiyan (nutrition mission) aimed at improving the nutritional status of women and children is now called as Mission Poshan 2.0. The language itself shows the intent of detaching from the outcome. In essence, rhetoric is paramount, and therefore, the programme shows immense scope of converting itself into a propaganda tool for the government, like the erstwhile Poshan Abhiyaan, which became a photo-op at the district level where service delivery replaced events. It is also very important to note from the budget speech of the Finance Minister that the focus is on the long term plan in terms of implementation. It is puzzling that there appears to be a need for the government to come up with its own five year plans after scrapping the planning commission, which did the very same thing! In fact, the erstwhile planning commission had provided pathways of setting up realistic timelines to achieve and if the goals are not achieved, then taking stock to strategize the allocation of budgets.
When the budget tells us a story of India’s response to the pandemic, it largely makes invisible the persistent pandemic of farmers suicide, out-of-pocket health expenditures done by the marginalised communities, Infant and maternal mortalities, deaths of children due to malnutrition and occupational deaths of the migrants. It will not be a 135% exaggeration to say that India ranks 123 among 162 nations in Gender Inequality Index. Another systemic health concern to our democracy is the 142nd position among 180 countries on the press freedom index.
In the summary document of the union budget, the finance ministry indicated that preventive and curative health shares complementarity with the well-being of the people. However, there is no mention towards the road map of the well-being of the population. At the time when the union budget was announced, Varavara Rao, G.N. Saibaba along with other political prisoners have been denied bail even when suffering from ill health. A comedian has been put behind bars as he allegedly could hurt the religious sentiment of majoritarian community. Does this relate in any way to a robust indicator in terms of the well-being off the citizenry? I think not!
Many would consider the above statements as an emotive approach towards our union budget and its relationship to our democracy. Maybe it is, maybe it is not. I would imagine that we ought to be emotive about the well-being and health of our citizens. But more importantly, what is critical is to examine what is ailing our ‘democracy’. The economic situation India is at peril. Do we need to even talk about the issues of political prisoners, women and children? Yes. What purpose would it serve for the betterment of the ‘economic’ situation of the country, if we do not care for the most vulnerable amongst us? To quote Virchow, Medical statistics will be our standard of measurement: we will weigh life for life and see where the dead lie thicker, among the workers or among the privileged.
 Quoted in ‘Infections and Inequalities’ by Paul Farmer.
[Disclaimer: Views presented above are those of the author and do not necessarily reflect those of CBPS]
Syed Mazahir Husain
Senior Research Associate, CBPS