Q.1) “India’s health financing system is a cause of and an exacerbating factor in the challenges of health inequity, inadequate availability and reach, unequal access, and poor-quality and costly health-care services” Discuss. suggest measures for improving health financing system in India.
India’s public spending on health continues to hover around 1% of GDP; accounting for less than 30% of total health expenditure.
- High out of pocket expenditures – Indians met more than 62% of their health expenses from their personal savings, called “out-of-pocket expenses”, compared with 13.4% in the US.
- a survey recently pointed that forecasted medical trend rate will be 10% in India, while inflation will be at 5%.
- With advances in technology, more resort to diagnostics which are often available in private clinics is pushing up the costs for the poor.
- A majority of the population living below the poverty line continue to rely on the under-financed and short-staffed public sector for its healthcare needs. We are 81% short of specialists at rural community health centres (CHCs).
- PHCs are short of more than 3,000 doctors, with the shortage up by 200 per cent over the last 10 years to 27,421.
Measures to improve:
- National Health Policy 2017 envisaged raising public spending on health to 2.5% of GDP by 2025
- Achieving universal health coverage through Public Private Partnership driven models.
- Developing Health infrastructure and maintaining quality standards
- Insurance penetration should improve; there is increased hope with schemes like the PMJAY
- The case of Thailand – In 2001, the Thai government established an autonomous Thai Health Promotion Foundation popularly known as the Thai Health. Funding for Thai Health comes from 2% dedicated tax on tobacco products and alcohol beverages, over and above the existing tax structure and the money is used for health promotional activities.
Q.2) The recent report on Trend and Progress of Banking in India 2017-18 points out slowdown in financial inclusion (FI) efforts. In this context discuss the main barriers that hinder the financial inclusion movement in India despite various steps taken by the government.
Barriers to financial inclusion:
- Usually, banks branches are located in the high densely populated areas for covering its cost of operations and people in rural area are often not covered.
- Due to lack of financial literacy the rural population relies mostly on informal sector for availing finance at exorbitant rates.
- Majority of the people’s income level in the rural area is low and irregular too. A major portion of people is in seasonal employment. Hence, income level decides the people’s saving and investment avenues.
- Majority of the poor people like migrants, tribes etc. cannot access the formal financial services due to lack of having any legal documents.
- Digital divide also limits the usage of modern financial technologies by the poor in rural areas.
Q.3) Public diplomacy is neither based solely on hard power nor relies fully on soft power, but needs generation of ‘smart power’. Elaborate.
The term hard power describes a nation or political body’s ability to use economic incentives or military strength to influence other actors’ behaviors.
Limitations of hard power:
- When there is deadlock between two nations usage of hard power further aggravates the problem.
- Hard power needs enough resources and financial capacity to generate, hence weak states doesn’t work for weak states.
- Usually results of coercive hard power are limited and backfire in later stages.
Soft power is persuasive power deriving from attraction and emulation and grounded on intangible resources like tourism, culture, and heritage.
Limitations of soft power:
- Soft power resource as cultural influence does not equal political power, which is direct and more influencing.
- Outcomes of soft power strategies depends on particular circumstances which cannot necessarily be influenced by states. For example, Buddhist heritage as a soft power can be used in Southeast and East Asian states, but not beyond.
- Soft power as a diplomatic tool works very slowly. There is no concrete strategy used in soft power and the changes are usually very subtle.
- Currently world is experiencing grave problems like non-state cross-border terrorism, direct belligerence like Chinese Doklam incursion which can be better dealt with hard power.
Smart power is defined as the capacity of an actor to combine elements of hard power and soft power in ways that are mutually reinforcing such that the actor’s purposes are advanced effectively and efficiently.
Q.4) Farmer Producer Organisations can be highly effective in giving bargaining power to individual and scattered farmers in India. Justify.
A Farmer Producer Organisation can be understood as a hybrid between cooperative societies and private limited companies.
How it helps the farmers:
- A FPO represents the power of aggregation. Many small farmers come together and form an organisation that collectively purchases inputs required by them and/or sell their produce.
- They adopt all the good principles of cooperatives and the efficient business practices of companies and also seek to address the inadequacies of the cooperative structure.
- They can undertake activities related to production, harvesting, procurement, grading, pooling, marketing, processing, etc., of agricultural produce.
- The Farmer Producer companies have democratic governance, each producer or member has equal voting rights irrespective of the number of shares held.
- Such connectors for ‘agro-industrialisation’ counter the problem of local unemployment
- They can strengthen farmers’ voice in instances of contract farming, where they have to negotiate with business groups.