Universal Healthcare never quite got the attention it needed from India’s policy planners. There were always other subsidies cooking and those had to be served first. This pushed healthcare investment out of the back burner and onto the kitchen floor. As a result, India’s governmental health spend is just 1% of its GDP, among the lowest in the world.
The main reason why it is always difficult to run a campaign for Universal Healthcare is because we fall sick singly and alone. When we are ill all we can think about is getting well. But when we are well, we don’t give illness a thought. An epidemic changes all that for illness now no longer strikes randomly and uniquely.
Covid-19, as we have seen, has linked whole masses together, the sick and the worried non-sick, like partisans in a movement. In this collective fight for life, corporate health tailored to suit individual capacity to pay, just doesn’t work. If it did, the US, the peer leader of privatised medicine, would not have also led the world in the number of Covid-19 deaths. Over 59,000 have already gone and even New York, the vibrant Big Apple, lies desolate and forlorn.
Italy’s Lombardy region was the most devastated by Covid-19 in all of Europe. It is no coincidence that from 1997, Lombardy began to aggressively privatise its erstwhile public health system. This even brought Arnold Schwarzenegger, then California governor, to visit Lombardy and publicly acclaim its officials for making this move.
Bergamo district in Lombardy was far ahead of others in this drive and, unfortunately, the death rate there was also disproportionately high. Cumulatively, this meant that Lombardy – with only 16% of Italy’s population – ended up with 66% of Covid-19 deaths in the country. If anything, this should introduce a serious rethink on privatised medical care.
Current Covid-19 mortality rates in the US show that Blacks and Hispanics have proportionately higher death rates than white Americans. In Milwaukee County, home to Wisconsin’s largest city, Blacks account for 70% of Covid-19 deaths, though they form only 26% of the population. The same picture emerges, with identical brush strokes, when we look at the fatality figures for Louisiana and Detroit. This was to be expected. Blacks and Hispanics are the poorest ethnic groups in America and a large percentage of them cannot afford private insurance. They are the ones who try self- medicating for as long as they can, fearing medical bills. When they cannot take it any longer and go to a hospital, it is often too late.
While about 70% of white Americans have private insurance, only around 50% of Blacks have that kind of backup. In New York City, Hispanics comprise 29% of the population but 34% of deaths. In the larger New York area, Blacks make up only 9% of the population, but 18% of deaths.
Americans have generally been quite wary of state run healthcare, but their experience with Covid-19 may bring about a difference. Independents, who tilt the scales in any major US policy issue, have gradually moved in favour of public healthcare. In 2013, only 41% of them were for state funded healthcare, but today this number has jumped to 62%. Also, Gallup poll reports the startling fact that a growing number of Republicans are beginning to turn their backs on privatised medicine.
In Britain, the government run National Health Service (NHS) was always very popular. A 2015 survey showed that as many as 89% of British people were strongly in its favour. However, many influential British Conservatives never supported the NHS.
In 2002, Boris Johnson tore into the NHS and called it “monolithic”, “monopolistic” and “unimprovable”. In his book ‘Friends, Voters, Countrymen’, he went on to suggest that “We need to think of new ways of getting private money into NHS.” In 2015 Jeremy Hunt, Conservative government secretary of health, even made a deal with Bain Capital (partly owned by Mitt Romney) for supplying blood plasma in the UK.
Over the years, cuts in NHS funding crippled its functioning. The state grant it received was just about enough for running costs with little left over for infrastructural upgrading, training and recruiting professionals. Fortunately, that attitude is all set to change; PM Johnson today is willing to rush into a burning building to save NHS. Why?
Well, it was the NHS that nursed Johnson to health after Covid-19 struck him. Which is why he is now a changed man, forever grateful to this state run service. If anything, this pandemic has shown that the rich and poor can be laid low equally. Consequently, those who once demonised public health delivery are ready to switch sides.
We see the ravages of Covid-19 in India as well. Once again, the overwhelming number of health professionals taking a bullet for us – doctors, nurses, ambulance drivers and paramedics – are public servants. Some years back a Universal Health cover proposal went out to the last UPA government, but that never quite got a foot in the door. One is often tempted to read left or right wing politics in healthcare, but really it is primarily, if not only, about citizenship.
Pandemics extract a terrible price but they teach us a fundamental lesson. When we fall sick together we realise the true value of staying connected.