The ravages of the second wave of the coronavirus are still fresh in our memories. In the early days of Covid-19, leading epidemiologists from across the world offered ominous projections about the pandemic’s course in the country, predicting an unimaginable loss of life and economic collapse unless the traditionally dichotomous (private-public, rich-poor) health system underwent a radical restructuring.
Many advanced the suggestion of nationalizing private hospitals into a consolidated state-run service, much akin to what happened in the UK after the Second World War, leading to the creation of the National Health Service (NHS).
What actually manifested was a legion of makeshift, complementary public-private collaborations which, presumably coupled with some inherent demographic and biological advantages, helped us endure the unprecedented pandemic.
Existing health programs, such as state and national public health insurance schemes, were built upon and expanded rather than revisited. This is not to remotely suggest that this was the best route we could have taken, as many of the systemic deformities that are traditionally owed to the large, unregulated for-profit healthcare sector assumed worse forms during the pandemic. However, what was palpable was the tenacity of the dichotomous system in enduring the worst shocks.
This today, paves the way for a liberal-conservative model of universal healthcare within a welfare state originally envisioned along social democratic lines.
First, a quick peek into history is warranted for a better understanding of where Indian healthcare is headed. The publication of the Beveridge Report in the UK towards post-war reconstruction, from which the tenets of the NHS were derived, was a defining moment in the history of modern welfarism. Quite in contrast to the Bismarckian social insurance paradigm, which believed in healthcare as an individual right, the NHS was built on the idea that ensuring basic levels of health and well-being were state responsibility, resulting in a tax-financed healthcare system free at the point of entry, and based on clinical need, thus ensuring equality of opportunity to all. Similar transitions characterized the US after the Great Depression, only to soon fizzle out in favor of a residual welfare state.
