Saturday, September 30, 2023

Government Funded Universal Healthcare: Indian Left’s Latest Evil Idea

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The Left figured that in many places, it was not readily possible to have Russia style total revolution in one go and capture power.

So they changed the tactics. Socialism is basically collectivisation, and collectivisation must necessarily lead to loss of all freedoms and finally totalitarian tyranny.

What they are doing now is collectivisation, sector by sector of economy. They have successfully captured education and popular culture in almost all democracies, and therefore people are not able to see this inexorable march of the Left through sectors, and incremental loss of their freedoms. In fact, electoral politics has come as gift of God to them. Using their control of education and media, they have convinced people that government is omnipotent, and it is government’s duty to provide them life’s necessities, without them having to pay for them. Politicians, to win elections, have played along, and are increasing taxes and giving away freebies with the money so obtained.

Of course as more and more people sign up for freebies, and tax base reduces as a result, all such systems finally end in chaos and collapse, as we have seen in Greece, Spain, Italy, and many Latin American countries. But Left makes sure that people are never able to connect dots. It makes sure that people never realise that all of them combined can not consume more than the total GDP of a country.

In India, they have already got enacted RTE, MNREGA, and Food Security Bill. All three are basically transfer of tax money to individuals, without the beneficiaries having to do matching work. And electoral arithmetic makes sure that no government will ever be able to discontinue these programmes. Once RTE, MNREGA, and FSB are fully rolled out, they will become huge permanent drain on exchequer, sucking precious Capital from the market and sinking it into a bottomless, jobless hole.

But the Left is not through yet.

It has now set its sight on Healthcare. Left claims that the government must ensure that each citizen has access to free healthcare of the same quality as a private hospital, say Jaslok, provides.

 

Of course as the article published in the Indian Express of today shows, even if we start spending our entire GDP on healthcare alone, we shall not be able to treat every Indian in Jaslok. But Left is working at it relentlessly. Articles advocating this routinely appear in newspapers.

And some government will soon go for it, as beginning has already been made through various Health Schemes funded by government.

Of course as there is no way we can fund such healthcare, there will be rationing. And because the privileged can not be subject to rationing, so we will have quotas: quotas for politicians, for government officers, for JNU and DU professors…..

And progressively more and more of our budget would go to fund the Healthcare, so investments in infrastructure would go, then expenditure on police and courts will be cut, then expenditure on army will be cut; and finally when still it will not be possible to treat every Indian in Jaslok, the country will collapse in chaos.

Modern healthcare is not something that was existing and the rich came and commandeered it for themselves. Modern healthcare has been developed in last hundred years or so, and it has a cost. Those who can afford it pay for it. It is an evil idea that those who earn money must be forced to fund somebody else’s healthcare. And even if for argument’s sake it is accepted that it is justifiable to do so when it comes to healthcare, there is not enough money even with those who earn to fund the healthcare of Jaslok standard for every citizen. Law has never created money or service that it makes people entitled to. But those who have been so made entitled to “free-something” rarely question the premise, or examine whether it is even possible. They prefer to burn cities if they do not get the entitlement. And vote out the politicians who try to tell them the truth. That is human nature.

The idea of government funded universal healthcare is evil idea, and must be resisted tooth and nail if India is to survive as a functioning country.

 

Excerpts from the Indian Express article are given below:

 

“ The typical European country with doubly universal health coverage spends around $4,000 per person per year to do so — higher than the total Indian GDP per capita.

Indians currently spend about $120 per capita (PPP) on healthcare each year, of which only a quarter comes from the government. Mexico, whose Seguro Popular universal insurance scheme is regarded as a model for upper middle income countries, spends nearly $1,000 per capita, with half coming from the government. Even the Mexican levels of government spending would require 80 per cent of all Indian taxes to be devoted to health — leaving almost nothing for anything else — infrastructure, police, education, defence, etc.

One positive feature of the discussion on UHC is that it recognises that the private sector can play a big role in being the producer of healthcare services, and that the government needn’t meet all healthcare demand through publicly owned and operated facilities. The political debate on UHC in most states is anchored around the popular stereotypes of cashless tertiary care through private and corporate hospitals being offered by insurance programmes like the Aarogyasri in Andhra Pradesh. The prospect of the poor being able to access expensive tertiary care, and that too at the same corporate facilities as the rich, is laced with deep social symbolism and populist appeal.

But programmes like Aarogyasri are a fiscal trap waiting to spring. They have not run into financial constraints yet because utilisation remains low. On the supply side, for tertiary services, private facilities can meet just a small share of the demand, despite their rapid expansion as incentivised by the programme. But, as their sharply increasing budgetary allocations show, it is only a matter of time before the fiscal threshold starts to bind. State governments would have no choice but to pare down fiscal support, thereby provoking a strong populist backlash. Already, these programmes have, by cornering the major share of state health budgets, exacerbated the weaknesses of public systems. Further, they will face populist demands for the ever-expanding coverage of medical conditions and treatment choices.

The perhaps paradoxical insight is that governments produce healthcare services and provide them in-kind, rather than finance services, because they are not committed to UHC but recognise the fiscal constraints. That is, when governments control the number of facilities and services to be offered, the fiscal commitment is limited and services are rationed. In contrast, if government promises to reimburse private providers for healthcare provided, the fiscal commitment is open-ended. Government facilities are a way of making the rationing implicit and hiding the lack of fiscal commitment to doubly universal health coverage.

Since India cannot afford doubly universal health coverage, there has to be an explicit discussion about how much of what type of universality should get priority. One approach is to make insurance with a near-universal list of conditions covered available for free to targeted citizens. This is the Rashtriya Swasthya Bima Yojana approach that has been emulated by several states and even the Centre. This approach limits the government’s fiscal commitment by covering only some individuals. There are two difficulties with this approach. First, even in this situation, without careful control costs will explode, both through increased use and increased costs per use. Second, this creates better health coverage for the poor that the middle class, who cannot afford private insurance, too would demand.” (from the article)

 

 

The whole article can be read here.

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