Q.1) Health care in India is obviously not egalitarian and becoming increasingly dependent on the private sector to deliver health care. Discuss and suggest measures for equitable medical care.
Answer: Of the total health spending in India, the government contributes just 29%. In the UK, the government’s share is 83%.
The health care services in India are not egalitarian. The out-of-pocket expenses for medical care are about 70% of all medical expenditure, enough to push a family into poverty.
Problems with present healthcare system:
- Poor government spending in healthcare is resulting in deteriorated standards in service provision from public sector. Indian government only spends about 1.4% of the GDP on the sector
- The gap between what is technologically possible and what government hospitals generally provide widened appreciably after the technological leaps in medical care – this can be called “medical rationing”.
- The deteriorating state of public healthcare in India means that an increasingly larger percentage of its citizens are being driven to the private sector for their medical needs.
- Mounting costs and decreasing availability of drugs is a major issue
- Medical rationing has other detrimental effects like creating distrust of the public in government hospitals.
Measures for equitable health care:
- The new Ayushman Bharat health scheme to provide secondary and tertiary care to those who are socioeconomically deprived.
- NITI Aayog’s document recommends the government to prioritise preventive care rather than provide curative care.
- AIIMS like institutions in every state to make tertiary care accessible.
- Generic medicines should be mandated and be made available.
- Niti Aayog suggested a model that provides for a greater role for private players in the India’s healthcare sector.
Q.2) ‘BRICS has grown in influence in its first decade but is still far from achieving its initial goals’. Discuss
BRICS is the acronym for an association of five major emerging national economies: Brazil, Russia, India, China and South Africa. It represents about 40% of the world’s population and 22% of global GDP.
How it grew in influence:
- New Development Bank is established to provide an alternative to IMF and WB led global multilateral financing.
- BRICS summit has been successful in terms of building a coalition of emerging markets that want to save multilateral trade regime
- BRICS Business Council has been actively enhancing trade and economic cooperation in diverse sectors
- “BRICS Plus” which began at Xiamen summit is a great opportunity for interaction among leaders.
Challenges in achieving its goals:
- Reform of global financial governance is still pending with NDB playing a limited role only. BRICS recently reiterated that IMF needs to better represent developing nations
- Democratisation of the United Nations is resisted by the powerful nations trying to retain their control.
- Expansion of the Security Council — because two of its members China and Russia do not want the other three members (India, South Africa and Brazil) to obtain parity in the global pecking order.
- Rising protectionism is affecting rules-based multilateral trading order.
- China’s dominance is growing and China-Russia proximity is a reality.
- BRICS Partnership on New Industrial Revolution (PartNIR) can make a contribution only if it goes beyond the ministries of industry and engage with private sector.
- Though BRICS outreach to Africa began in 2013, it has picked up momentum now. African nations need big loans from the New Development Bank (NDB) for their infrastructure projects.
- China introduced the “BRICS Plus” format at the Xiamen summit last year. The precise role of “BRICS Plus” is yet to be understood.
- No decision was taken to set up the BRICS credit rating agency that India favours.
Q.3) Why does equality matters? How do we distinguish between political, economic and social dimensions of equality?
Answer: The preamble of Indian constitution guarantees its citizens equality of status and opportunity.
Importance of equality:
- Equality is very important because our society did not practice equal access in the past. The practice of untouchability is one of the crudest manifestations of inequality.
- Equality makes India a true democracy by ensuring equality of dignity and status.
- Equal opportunity means that government can implement special schemes and measures for improving the conditions of certain sections of society: children, women, and socially and educationally backward classes.
- It invokes the idea that all human beings have an equal worth regardless of their colour, gender, race, or nationality.
- Some differences which are considered natural need no longer be seen as unalterable. For instance, advances in medical science and technologies have helped many disabled people to function effectively in society. Today, computers can help blind
Dimensions of equality:
- Political Equality – Political equality would normally include granting equal citizenship to all the members of the state. Equal citizenship brings certain basic rights such as the right to vote, freedom of expression, movement and association and freedom of belief. These are rights which are considered necessary to enable citizens to develop themselves and participate in the affairs of the state.
- Social Equality – Political equality only legally guarantees access to goods. But pursuit of equality requires that people belonging to different groups and communities also have a fair and equal chance to compete for those goods. For example, some of the customs deny women equal rights of inheritance.
- Economic Equality – Economic inequality exists in a society if there are significant differences in wealth, property or income between individuals or classes. Equal opportunities available to people would those who have talent and determination the chance to improve their condition.
Q.4) What is meant by social constraints? Are constraints of any kind necessary for enjoying freedom? What is the difference between the negative and positive conception of liberty?
Social constraints : Given the diverse interests and ambitions of people any form of social living requires some rules and regulation. These rules may impose some constraints to on the freedom of individuals and are called social constraints.
Constraints are needed for freedom:
- Some constraints may free us from insecurity and provide us with the conditions in which we can develop ourselves.
- We need some constraints or else society would descend into chaos. Differences may exist between people regarding their ideas and opinions, they may have conflicting ambitions, they may compete for scarce resources.
- Sme legal and political restraints ensure that differences may be discussed and debated without one group coercively imposing its views on the other
Constraints not needed for freedom:
- In South Africa, the constraints imposed by the apartheid regime discriminated between citizens based on their race.
- Constraints on freedom from social inequality like in the caste system and based on economic inequalities are not desirable.
- Constraints limit an individual from enjoying equality of status and opportunity.
- Also state most of the times limits the freedom of individual in the name of larger public interest. Here the check should be the extent of compromise of individual freedom and the importance of national interest. The debate between Fundamental Rights and DPSPs is an example.
As freedom is at the core of human society, is so crucial for a dignified human life, it should only be constrained in special circumstances. The ‘harm caused’ must be ‘serious’.
Difference between +ve and -ve liberty:
Negative liberty’ seeks to defend an area in which the individual can ‘do, be or become’ whatever he wants. This is an area in which no external authority can interfere. It recognises that human nature and dignity need an area where the person can act unobstructed by others.
‘Positive liberty’ is concerned with looking at the conditions and nature of the relationship between the individual and society. It recognises that one can be free only in society (not outside it) and hence tries to make that society such that it enables the development of the individual.