Shruti Pushkarna: Statistics Sans Substance: Are welfare schemes accessible and affordable for all?

06 Oct,2022

Shruti PushkarnaBy Shruti Pushkarna

 

I enjoy my mornings this time of the year in the capital. A slight nip in the air, fresh breeze with lush green trees swaying gently, and my steaming cup of tea. And the most important ritual, skimming through the dailies. Yesterday, I came across a nearly full-page advert in The Indian Express which incited a flurry of emotions in me. Yet another self-aggrandising propaganda of our dear Prime Minister. Needless to say, the newspapers these days are filled with life-size pictures of Narendra Modi and his government’s pathbreaking (sarcasm alert) feats!

 

The headline that caught my attention was: ‘Accessible and Affordable Healthcare Services Assured for All’. Now we all understand the term affordability especially in the backdrop of poverty facing a large section of the Indian population. As for accessibility, it includes access to the service from awareness of what it entails, how to avail and where from. I’m not even getting into the meaning of access or the lack of it, specific to persons with disabilities.

 

 

The exact quote from the Prime Minister read: “Making the best treatment accessible to all is the country’s vision for a healthy India in the Azadi Ka Amrit Kaal. Today, India’s health policy revolves around health for all.”

 

And this was followed by the usual number citing of modern and accessible health facilities for citizens. Of course, there was also the expected photo of a ‘needy’ man looking hopefully at the average Indian’s messiah (read Modi).

 

As I said, it triggered multiple emotions inside me. Annoyance, at the unnecessarily rosy portrayal of reality. Frustration, at the indifferent usage of the word ‘accessible’. Disgust, at the never-ending convenient misconstrued usage of numbers.

 

Data show-off is a favourite tactic of ruling parties, be it the current government or their predecessors. The advert in question states, “More than 50 crore poor can access free treatment up to 5 lakh rupees per family per year through Ayushman Bharat Pradhan Mantri Jan Arogya Yojana”. The number of health centres and additional medical colleges is reassuring (however misleading) to a naïve reader. But what’s the truth behind these out-of-context numbers?

 

Last month, I was staring at the growing pile of clothes that sat in one corner of my room, because the ironing lady didn’t show up. My car was covered in dust for days as the car cleaner went missing. On asking around, I learned that the couple was reeling under their unexpected share of miseries. The guy fell down and ended up paralysed in a hospital, where the family couldn’t afford the necessary treatment. They had to rush to another hospital where he was operated, with a glimmer of hope for some sensation to return in his legs. For now, he is ‘disabled’, without an income and a handsome loan with no means to repay.

 

When I asked his wife why they didn’t avail the Ayushman scheme, she said, “only if it were that easy”. That’s the naked truth. Simple and sharp. This woman is now working hard to run the house, look after her kids and ensure somehow that her husband receives treatment to spring back into action. She cannot afford the unforeseen yet unavoidable healthcare expense, and neither can she access the so-called welfare scheme.

 

I wonder if this distraught woman believes in the PM’s vision of accessible and affordable healthcare for all.

 

Meanwhile, residents like me have found a new guy who can iron clothes as well as clean cars. And I’m sure we sip our tea in peace, looking at the elaborate advertisements celebrating Azadi Ka Amrit Kaal.

 

According to the National Health Accounts (NHA) estimate for 2014-15, the Government Health Expenditure (GHE) per person per year is only Rs 1,108 that comes to Rs 3 per day. Reports indicate that India’s public health spending is less than lower-income countries like Bhutan, Sri Lanka and Nepal. 0.38 million people committed suicide in India between 2001 and 2015 due to the lack of treatment facilities, as stated by the National Crime Records Bureau.

 

After the pandemic, the healthcare needs have amplified and so has the spending but is it enough for every section of the population? What about the disabled community or those who have acquired disability after contracting Covid? This includes invisible disabilities like brain-fogging and loss of smell, both of which I have experienced personally.

 

Speaking of persons with disabilities, during the pandemic, another social security scheme was promoted by the leadership and the news media. The famous Antyodaya Anna Yojana, under which every beneficiary could claim 35 kilos of ration, including 20 kilos of wheat and 15 kg rice. Handling the backend operations of a national helpline for blind and visually impaired people, I was faced with distressed accounts on a regular basis as Covid numbers were on the rise.

 

When people called asking for ration, the helpline redirected them to district and village officials to avail the Antyodaya Yojana. But most callers reported denial of ration, on account of disability or incomplete paperwork. This when the central and state governments were heavily advertising the simplicity in access of the said welfare measure for ‘all’. True that a lot of people received free ration during the troubled times, but an equal (or more) number of folks faced brutal rejection at the hands of implementing agencies.

 

Persons with disabilities were stranded without help, food, or medicines, and some even without proper shelter, during the lockdown. For them, fear emanated more from how they would be able to access healthcare in case they contracted Covid rather than how the disease would impact their physical being.

 

Where is the data that speaks for the people? I can understand that it may not be in the best interest of governments to reveal such insights, but what is preventing the news media from doing so? Are the woes of an average citizen not glamorous enough to feature alongside blatant agitprop in newspapers, or on primetime television debates?

 

Shruti Pushkarna is a former journalist who now works as Director, EnAble India where she heads North India operations as well as media and communications outreach. Shruti writes for MxMIndia every other Thursday. Her views here are personal. She can be reached via Twitter at @shrutipushkarna

 

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