Health Policy and Legislation

Measures like disciplining and quarantining are associated with the governments’ extraordinary powers during unprecedented times. In this context, the biopolitics of the ongoing COVID-19 pandemic is discussed. When the steps taken by the government to contain the spread of coronavirus are failing, we need new imageries to tackle the challenges that lie ahead of us.

The Pradhan Mantri Jan Arogya Yojana is an ambitious health insurance scheme that has been touted as an important tool to achieve universal health coverage. However, there is still no clarity regarding the financial implications of this scheme. Based on National Sample Survey data of 2004 and 2014 on hospitalisation rates and average medical expenditures, three alternate scenarios have been analysed based on different assumptions about these two parameters, to estimate the total costs of the programme. The results indicate a potentially high burden of the programme on the state and union government finances, especially if it is successful in covering all the intended beneficiaries.

The number infected with SARS-CoV-2 in early May in India is estimated by a method utilising the unequivocal number available, namely deaths due to COVID-19. The estimated numbers are far in excess of reported numbers and indicate the systemic flaws in reporting deaths in India, augmenting the extent of underestimation. Additionally, there is the overestimation of the doubling time of infection. A realistic picture of the epidemic at the community level is presented, which informs us about the level of preparedness required to deal effectively with the epidemic.

The challenges before the components of Ayushman Bharat, the (ir)rationality behind raising the insurance coverage manifold are highlighted, a political economy narrative of the changing health financing scenario is drawn, and how the design of Ayushman Bharat will feed into executing the proposed public–private partnership model in public facilities and facilitate the strategic purchasing agenda of the National Health Policy is examined. Ayushman Bharat is a step towards creating a system that would facilitate in relinquishing public funds and public institutions to already dominant private players, which will have serious implications for the healthcare delivery system in India.

The relevance, provisions and the implications of the National Medical Commission Act, 2019 for the future of medical education and health practice in the country are examined here. This act is a step towards improving governance and introducing reforms with the potential to create an enabling environment, and facilitate standardisation in processes and transparency in the functioning of the health sector.