Explainer: Rahul Gandhi's Three Promises and One Criticism on Healthcare

The party wants to increase health spending and the number of professionals in the field, apart from ensuring a ‘right to healthcare’.

New Delhi: On Friday, Congress president Rahul Gandhi addressed a group of healthcare professionals in Chhattisgarh. He talked about three healthcare promises which the Congress is considering making in its 2019 election manifesto.

According to Gandhi, the party is considering an increase in health spending to about 3% of the GDP. It is also thinking of bringing a ‘right to healthcare’ legislation and increasing the number of professionals in the field.

Congress leader P. Chidambaram said that the increase in health spending will happen at a point between 2019 and 2024, and not necessarily in 2019 itself, if the party wins. The BJP government had released a National Health Policy in 2017, which proposed that health spending should increase to 2.5% by 2025. The Congress, thus, is promising a greater increase than the BJP in less time.

The second potential manifesto promise on healthcare is a ‘right to healthcare’ act.’ “Through a Right to Health, we will guarantee universal access to health services, including diagnostics & medicines for both outpatient care and hospitalization,” tweeted Congress leader Rajeev Gowda.

Chidambaram said that this would happen through the public health system, in which drugs and diagnostics are already supposed to be free.

Thirdly, Gandhi suggested that the party wants to increase the number of healthcare professionals. Chidambaram explained that the Congress intends to increase the number of doctors through establishing more medical colleges and giving more loans and scholarships to students.

Gandhi made special mention of the number of stakeholders in the health industry – including ASHA workers, doctors and other medical professionals and businesses.

Also read: Explained: Why Healthcare Reforms Should Be an Election Issue in 2019

On health insurance, Gandhi criticised the BJP’s Ayushman Bharat scheme, which has promised a coverage of Rs 5 lakhs to 10 crore of India’s poorest families. “It is a handout to the richest businessmen in India,” he said.

He said it targets a limited number of healthcare issues (for example, the current scheme only caters to a person’s ‘in-patient’ expenses but most Indian patients incur costs without being admitted to a hospital), and that it promises insurance but “without a proper support structure from hospitals and medical professionals”.

He suggested that his party may want to rework Ayushman Bharat, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY).

Gowda soon tweeted that the party’s focus will be on “health assurance not insurance”. Health assurance is different from health insurance. Assurance goes beyond just treatment or cure and looks at prevention. It is interested not just in the scientific or financial aspect of a disease, but in the entire health ecosystem. Insurance looks solely at paying for the treatment of diseases which have already occurred.

On this, Gowda said the Congress hopes to make public hospitals “the first choice for patients”.

This is very different from how the BJP is channeling Ayushman Bharat. As The Wire reported in January, the government is trying to send India’s poorest to private hospitals to get treatment under the scheme. It is even offering to pay private players to set up more hospitals.

The head of the scheme tweeted that it wasn’t just going to benefit a few businessmen, as Gandhi claimed. “This is incorrect. We are benefiting 50 crore poorest people in the country and not 15-20 rich ones,” said Indu Bhushan.

Several civil society organisations have been releasing their own manifestos – containing what they think should constitute the next government’s healthcare priorities. The Wire reported on some of these in February.

Some of these recommendations include “abandon Ayushman Bharat”. Nearly all of them call for an increase in healthcare spending.