On June 18, 2019, Forum for Medical Ethics Society (FMES), Mumbai organized the 127th WHO Global Health Histories seminar in collaboration with Centre for Global Health Histories (CGHH), University of York, United Kingdom; the Centre for Law and Society, School of Law, Rights and Constitutional Governance & the Centre for Public Health, School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai; and Centre for Policy Studies, IIT Bombay.
The seminar was addressed the theme ‘Towards Universal Health Care: History of ‘Health for All’ Struggles in India’. It was divided into three sessions with presentations and Q&A rounds, wherein the attendees could get informed about the various topics by the presenters, and then ask pertinent questions regarding the topics.
In the first session Amar Jesani, Editor, Indian Journal of Medical Ethics gave a presentation on ‘Bhore Committee to Astana Declaration: Towards ‘Health for All’ wherein he presented the history of the movement towards the goal of ‘Health for All’. He began by speaking about the community health plans that had been a success at the local project level but could not be a success at a national program level because of lack of support at the referral level. He stated that the issue was often about providing of care at the secondary and tertiary level, and that a view had been articulated that primary care could be provided by public health while secondary and tertiary care could be provided by private health sector. This led to private sector growing stronger while the public health system stagnated. He also spoke about the recommendations of the Bhore Committee(1946), the Alma Ata(1978) and Astana(2018) declarations. Abhay Shukla, National Convenor, People’s Health Movement-India, Pune, spoke on History of People’s Health Movement-India and JSA’s People’s Health Manifesto . He spoke about the trend of the governmental budget of the primary health services going down. He spoke about ‘social liberalism’ that centered around the idea of giving to the poor without taking from anyone, likening it to making omeletes without breaking eggs. He also discussed the need to educate people about their rights when taking private health care while maintaining that it was necessary to develop the public health sector. The presentations were followed by a Q&A round. During the Q&Q, in response to a question on how to engage with CSR and the funding that came with it, Amar Jesani touched upon CSR actually means vis-a-vis what it is being done in the name of CSR. In response to a question on health insurance, Abhay Shukla likened the relationship of health insurance and the terrible state of public health care to unhygienic bottled water and publicly available tap water wherein an individual solved a problem in response to a public societal problem that allowed the individual to cope with the societal problem without solving it.
In the second session, Ravi Duggal, Independent Researcher and Health Activist, Mumbai gave a presentation on the Political Economy of Healthcare Financing in India: Saying No to Insurance, which included the historical antecedents of health financing in India. He elucidated about the historical antecedents of health financing in India, and compared the state of private health care in the 1970s to the current political economy of healthcare. He advised strongly against young people taking health insurance while pointing out that the elderly who needed it were not given it or had to pay high premiums for it. He gave the example of the US where the prevalence of health insurance had skewed the cost of health care because the health companies could excessively charge the patient based on how much money the policy could pay the practitioner or institute. Following his presentation, Sulakshana Nandi presented her data on Equity, access and utilization in the state funded universal health insurance schemes: Implications on Tribal groups. She gave examples of poor tribal who had not been able to take advantage of the publicly funded health insurance(PFHI), and how out-of-pocket expenditure still occurred. Meanwhile, those who did manage to avail of the PFHI considered it to be a form of discounting of costs rather than an complete doing away of the financial burden of illness.
- Program schedule
- Photo Galley
- GHH Seminar 127: History of ‘Health for All’ Struggles in India – Video (Part 1), (Part 2)
Supported by Tata Trusts