MAINS DAILY QUESTIONS & MODEL ANSWERS:
Q1. The Pradhan Mantri The Jan Aarogya Yojana faces numerous obstacles as it works to advance India’s healthcare system. Discuss. (250 words)
Paper & Topic: GS II Social Sector of India – Health.
- The Pradhan Mantri Ayushman Bharat’s Jan Arogya Yojana (PM-JAY) was created with the intention of easing the financial burden placed on the poor and vulnerable groups as a result of catastrophic hospital episodes and ensuring their access to high-quality medical care.
- It will provide benefit coverage worth Rs. 500,000 for each household each year (approx. 50 crore beneficiaries). Almost all secondary care and the majority of tertiary care operations will have their hospitalisation and medical costs covered by PM-JAY.
- The programme undoubtedly has the laudable intention of providing the best medical care at the lowest costs to the less fortunate and economically weaker segments of society. There are several obstacles in the way of the program’s success.
- India’s public healthcare spending between 2008 and 2015 has essentially remained flat at 1.3% of the national revenue. Implementing a programme that may cost Rs 5 lakh per person and help 53.7 crore of India’s 121 crore citizens, or roughly about 44% of the population, is a monumental task. The issue is probably going to get worse in the future because healthcare inflation has a history of rising faster than general inflation.
Physician Density Ratio:
- According to the WHO, there are 8 doctors for every 10,000 inhabitants in India. It takes more than more basic and secondary healthcare facilities to provide this access. Access ought to be fair. The development of infrastructure and the number of healthcare facilities should coexist.
Government populist measures:
- It has long been controversial to include Above Poverty Line (APL) people working in the unorganised sector in the scope of a programme. Most lower middle class and middle class households with income earners who work in the unorganised sector would still have a large portion of their members without insurance. This part wouldn’t be insured due to the high insurance cost in comparison to PMJAY.
Inequality of treatment between public and private hospitals:
- This has been a major concern as public hospitals would continue receiving budgetary support. The private players would be discouraged from actively taking part in the plan as a result.
Additional rewards for private participants:
- When there are incentives from the State, private players may establish hospitals in disadvantaged areas. Without it, the current state of shackled last-mile medical care would continue.
Insufficient IT support infrastructure:
- Even before the essential systems and processes have been fully established and validated for their resilience, the programme is being launched hastily. This has caused many impoverished people to remain in poverty as a result of ongoing out-of-pocket expenses.
- Since public health is a state concern, the state government is the primary factor in determining PMJAY’s success.
- According to past centrally funded programmes, line ministries frequently imposed an excessive number of standards and regulations, emphasising a top-down approach.
Steps to Take:
- It is not necessary to incorporate the APL population right away, but rather, say, in a few years.
- Focus on the APL’s penetration of health insurance for time-beng.
- Budgetary support for public hospitals could be used to entice private firms to invest in underserved areas.
- Less involvement from the government should be allowed under the National Health Authority, which was established as an autonomous authority, allowing private parties to participate.
- In order to remove policy uncertainty and facilitate investments in hospital infrastructure, a legally enforceable policy commitment is essential.
- In order to achieve Universal Health Coverage (UHC) and Sustainable Development Goal – 3, PM-JAY wants to hasten India’s progress in these areas (SDG3).
Q2. Repeated loan exemptions may benefit political parties, but farmers do not stand to gain from them in the long run. Discuss. (250 words)
Paper & Topic: GS III Indian Agriculture.
- The practise of waiving agricultural debts refers to the act of writing off loans made to farmers who are unable to repay them due to calamities, disasters, governmental policies, etc.
- Similar actions have been taken in states controlled by other parties since 2014, including Telangana, Karnataka, Andhra Pradesh, Maharashtra, Uttar Pradesh, Punjab, Rajasthan, Madhya Pradesh, and Chhattisgarh. Loan waivers have become into a powerful political tool in the hands of political parties, ruining the financial standing of Indian agriculture.
- According to the 2013 NSSO Situation Assessment Survey of Agricultural Households, 52% of farming households had debt, with percentages reaching 89–92% in some States.
For the wellbeing of farmers, agricultural loan waivers are required:
- India’s agriculture has been struggling with a number of problems, including fragmented land ownership, declining soil quality, falling water table levels, rising input costs, and low production. Add the monsoon’s whims to this.
- The cost of the output might not be profitable. Farmers frequently have to take out loans to cover their expenses. Additionally, many small farmers who are ineligible for bank financing borrow from private sources at excessive interest rates.
- Farmers who are drowning in debt must make difficult decisions when nature tramples them under the foot with unpredictable monsoons and crop failures. One of the main causes of the numerous farmer suicides in the nation is debt.
- Loan forgiveness is more in the interest of political parties than it is of farmers’ welfare:
- Political parties typically declare loan waivers in order to boost their electoral prospects. The very reason for waiving is unjustified, and the entire waiving procedure has to be reviewed.
- The burden of high-interest loans that banks lend to small business owners and dealers comes from the fact that farm loan exemptions have evolved into electoral weapons for parties.
- The great majority of small and marginal farmers who lack access to formal credit and are in debt to local money lenders are not taken care of by farm loan waivers. According to a RythuSwarajyaVedika research published in June 2018, tenant farmers in Telangana account for 75% of farmer suicides and have the least or no recourse to official finance.
- Waivers for farm loans are at best a short-term fix and present a moral hazard because even those who can afford to pay may choose not to do so in anticipation of a waiver.
- Such actions may weaken credit standards and discourage banks from lending to farmers in the future. Additionally, it severely damages the government’s finances, which pay for the write-off. Similar opinions about “Moral Hazard” have also been stated by former RBI leaders Urjit Patel and Raghuram Rajan.
- Furthermore, according to a recent report by the International Food Policy Research Institute, 48% of farming households nationwide do not receive a loan from any source. 36% of the borrowing households use unofficial sources of credit.
- Farm loan waivers do not improve the welfare of farmers because there is a negative correlation between the size of the farm and per capita consumption expenditure (a proxy for income), which further emphasises the importance of formal credit in assisting marginal and poor farm households in reducing poverty.
What should be done?
- A functioning institutional credit system that is open to and answerable to all cultivators is what is meant by “credit, finance, and insurance.”
- This includes all farmers, including landowners, tenants, adivasi and women farmers, sharecroppers, and animal-rearing farmers.
- Agriculture credit products need to be specially designed for each region’s cropping and rainfall patterns. Commercial banks’ regional branches ought to participate in this endeavour. issuing Kisan credit cards and registering all growers.
- Given that the spatial distribution of rain patterns in India is irregular on average every second or third year, the term of the crop loan should be extensible to four years.
- Reduced costs of seeds, fertiliser, and other inputs are more crucial to ensuring the sustainability of agriculture.
- Reimbursable Prices: It’s critical to expand the application of the minimum support price, which is now restricted to a small number of crops and a constrained geographic area.
- As an alternative to distress sales, setting up futures and trade markets and partnering with private enterprises for procurement should be considered.
- Agro-Produce Marketing and Processing: In order to store agricultural products when prices fall, the agro-processing sector and warehouses must grow.
- encouraging functional farmer cooperatives to serve as a “collective voice of marginal and small farmers.”
- All states should pass legislation modelled after the new model law created by NITI Aayog, the Agricultural Produce and Livestock Marketing (Promotion and Facilitating) Act (APLM).
- Technology: The use of tools like drip and sprinkler irrigation to help farmers.
- Drought-prone areas should be encouraged to use precision agriculture and GM crops.
- Mobile devices and space technology should serve as the farmers’ “Eyes and Ears” to help with farming.
- Establish commissions for farmers in distress and disaster relief at the federal and state levels, modelled after Kerala’s Farmers’ Debt Relief Commission.
- Loans should only be waived in the most extraordinary situations. In contrast to interim measures like loan waivers, political parties and governments face a struggle in providing the institutional answers that farmers are calling for.