ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Articles By Ravi Duggal

Political Economy of Brihanmumbai Municipal Corporation Budgets

The paper focuses on the changing trends in budget allocations of the Brihanmumbai Municipal Corporation, especially since the structural adjustment programme that came to be implemented from 1990 and how it has affected civic services, especially health and education. The paper concludes that it has increasingly directed public resources to the private sector and reduced access adversely access to both healthcare and school education for Mumbaikars.

 

Mumbai’s Struggles with Public Health Crises

The economic catastrophe precipitated by the COVID-19 pandemic and the response of the dismal public health system has actually led to the heightening of the public health crisis. If the migration of workers from cities is not stopped through appropriate economic support measures, the public health crises will worsen because most migrants are returning to states that have very poor healthcare systems with limited capacities to deal with such crises. This pandemic also offers a political opportunity for governments to focus on strengthening the primary healthcare and public health systems through bold experimentation and strategies.

User Charges Onslaught on Public Health Services

Healthcare as a public good should be available free of charge at the point of service delivery. This was the case across India until a flurry of reforms from the early 1990s onwards notified user charges for various health services in public health facilities. Since then, public expenditure on healthcare has seen a decline from a high of 1.5% of gross domestic product in the mid-1980s to a low of 0.7% of GDP in the mid-1990s, recovering to 1.2% of GDP presently. However, out-of-pocket healthcare expenditure has risen dramatically with increased user charges in public health facilities, which leads to further inequities.

The Case for a Parliamentary Budget Office in India

It remains notable that the quality and comprehensiveness of the budget scrutiny process through the debate and the standing committees is weak. Parliamentary scrutiny of public finance is a very important aspect for holding governments accountable to the people. Strengthening Parliament’s oversight apparatus calls for proper attention and requires a thorough overhaul. Establishing a Parliamentary Budget Office, an independent and impartial body linked directly to Parliament, is a fitting response to this concern.

Saving the Employees' State Insurance Scheme

The central government seems to be moving towards dismantling the most important social health insurance programme for the organised sector working classes, the Employees' State Insurance Scheme. The government is extending health benefits to the unorganised sector through targeted and restricted schemes using the route of private health insurance, but all these efforts fail to have the intended impact and end up benefiting the private hospitals and the insurance companies. Serious efforts must be made to iron out the design defect in the Employees' State Insurance Scheme and universalise it.