Note4Students
From UPSC perspective, the following things are important :
Prelims level: Not much
Mains level: Paper 2-Universal health coverage in India
The article analyses the issues India could face in implementing the universal health coverage.
Context
- Both India and the U.S. leads the Covid cases in the world and also lack effective universal health coverage (UHC).
What explains the lack of UHC in both the countries
- The lack of UHC is due to multiple long-standing factors and historical reasons that have put a damper on the UHC agenda.
- This long legacy has two important and inter-related implications when it comes to health-care reform.
- 1) Certain foundational aspects of these health systems that have been adopted over decades tend to dictate the terms of further evolution and lead to a number of compromises.
- 2) The long legacy itself comprises a path-dependent trajectory that precludes far-reaching health-care reform.
- This applies both to AB-PM-JAY and NDHM.
India’s attempt at UHC: Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana
- The government has looked poised to employ Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PM-JAY) health insurance as the tool for achieving UHC.
- Taking the health insurance route to UHC driven by private players, rather than strengthening the public provisioning of health care, is reflective of the non-negotiability of private health care in India.
- Covering the remaining population under the AB-PM-JAY presents massive fiscal and design challenges.
- Turning it into a contributory scheme based on premium collections would be a costly and daunting undertaking, given the huge informal sector and possible adverse selection problems.
- Distributing benefits among various beneficiary groups, and a formalisation and consolidation of practices in a likely situation of covering outpatient care, are formidable additional challenges.
- One possible advantage for India over the U.S. could be a relative ease of integrating fragmented schemes into a unified system. The AB-PM-JAY has this ability.
Issues with AB-PM-JAY
1) Universal insurance will not be universal access
- In India, almost two-third corporate hospital are located in cities.
- So, such maldistribution of health-care facilities and low budgetary appropriations for insurance could mean that universal insurance does not translate to universal access to services.
- So far, insurance-based incentives to drive private players into the rural countryside have been largely unsuccessful.
2) Lack of regulatory robustness
- AB-PM-JAY is without enough regulatory robustness to handle everything from malpractices to monopolistic tendencies.
- This could have major cost, equity, and quality implications.
National Digital Health Mission (NDHM)
- Integration and improved management of patient and health facility information are sought through NDHM.
- But in the absence of robust ground-level documentation practices and its prerequisites, it would do little more than helping some private players and adding to administrative complexity and costs.
Consider the question “What are the challenges India faces in the implementation of universal health coverage? Suggest the measures to achieve it.”
Conclusion
Upheavals offer a window for reforms. We cannot afford to be complacent and think that the pandemic will automatically change the Indian health-care landscape. It will require mobilising concerted action from all quarters.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: Not much
Mains level: Paper 2- India-China relations
The article analyses the India’s efforts to establish strategic equilibrium with assertive China and how that idea clashes with China’s desire to form an Asian order with itself at the top.
Strategic equilibrium
- External Affairs Minister S Jaishankar articulated that India is seeking strategic equilibrium with an increasingly aggressive China.
- It is hoped that with China’s growing differences with the U.S. China would pay attention to India’s sensitivities.
- In achieving equilibrium with China, India has bravely been confronting a face-off in the Himalayas for the past several months.
- India has been building issue-based alliances with the US and Asian majors like Japan, Korea, Vietnam and Indonesia, and Australia.
- It has taken initiatives in the direction of economic de-coupling with China in the name of “atmanirbharata”.
Hierarchical Asian order with China at top
- China is not interested in equilibrium with any of its Asian neighbours, least of all with India.
- China’s efforts are clearly to build a hierarchical Asian order, with itself at the top.
- It is acutely conscious of India’s economic strength, military modernisation and overall capabilities.
- It knows that India is also far behind on these counts.
- China is ruthlessly resisting India’s access to global governance bodies, such as the UNSC and NSG.
- To keep India tied at that level, China is objecting to India’s growing strategic proximity to the US. I
- It is encircling India strategically and economically through its strategic and economic corridors — BCIM (Bangladesh, China, India and Myanmar), CPEC and the Trans-Himalayan Connectivity Network.
- It is raising issues like Kashmir at the UN and establishing footprints in the Indian Ocean.
What should India do
1. Adjust with China, at least tactically.
- Such an adjustment could be based on mutual give and take.
- For India, our first priority could be the resolution of the border dispute.
- Secondly, since China has offered to mediate between India and Pakistan, it should be asked to prevail over Pakistan to resolve the Kashmir issue.
- In return for these “takes” India could offer access to Chinese commercial cargos to sea, through the Nathula pass.
- India could also join China’s BRI on mutually acceptable terms.
- India may also show its willingness, at least tactically, to join CPEC as both Pakistan and China have asked for, provided, India is allowed to undertake projects in PoK and Balochistan.
2.India should revisit its Tibet policy, which is a core irritant for China.
Consider the question “China seeking to establish an Asian order with itself at the top comes in the way of India establishing strategic equilibrium with China. Comment.”
Conclusion
It is possible that this “give” and “take” may not be acceptable to China. Even if it does not work out as planned, India would have made a bold diplomatic initiative and a huge tactical move towards thinking through out-of-the-box solutions and displaying that it can undertake risks to pursue its long-term national interests.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: Not much
Mains level: Paper 2- Evolution of the idea of strategic autonomy
The article analyses the evolution of India’s approach to strategic autonomy from the unipolar world dominated by the U.S. to now when the Chinese threat has been looming large.
Context
- Addressing a Southeast Asian forum last week, external affairs minister outlined India’s new quest for “strategic autonomy” in its global economic engagement.
Connection with Atmanirbhar Bharat
- This new quest for “strategic autonomy” is the natural external complement to new economic strategy, described as “Atmanirbharata” or “self-reliance”.
- The concept carries so much ideological baggage, its revival by Government inevitably raised many questions
- Senior ministers and officials of the NDA government sought to reassure India’s partners that Delhi was not marching backwards.
- When applied to the foreign policy framework, “self-reliance” becomes “strategic autonomy”.
Evolution of the idea of strategic autonomy
- America towered over the world after the collapse of the Soviet Union in 1991.
- India’s past emphasis on strategic autonomy was in the context of the “unipolar moment” [dominated by the U.S.] that emerged after the Cold War.
- On the one hand, India needed Western capital as well as technology and better access to its markets.
- On the other hand, Delhi had to protect some of its core national interests from the threats of US intervention.
India-U.S. Relations: Evolution after the Cold war
- In the early 1990s, the Clinton Administration strong desire to resolve the Kashmir dispute between India and Pakistan.
- The Clinton Administration saw the nuclear and Kashmir disputes as one and the same thing.
- Indian diplomacy for the next two decades tried to change the US policy on both Kashmir and nuclear issues.
- Under President George W Bush, the US discarded the long-standing temptation to insert itself in the Kashmir dispute.
- The US also went out of the way to resolve the nuclear dispute with India by changing its domestic laws and international norms on nuclear proliferation.
- The Obama and Trump Administrations have stayed the course since then.
China challenge for India
- On the atomic front, as the US sought to lift the prolonged atomic blockade against India, China sought to block the process.
- China turned an obstacle to India’s membership of the Nuclear Suppliers Group.
- China takes up the Kashmir issue regularly in the United Nations Security Council.
- Today, India’s strategic autonomy is about coping with China’s challenge to India’s territorial integrity and sovereignty.
- China today is viewed in Delhi as a major threat to India’s economic development.
- The bilateral trade deficit reached nearly $55billion in 2019.
- India pulled out of an Asia-wide free-trade arrangement called the Regional Comprehensive Economic Partnership late last year, sensing the threat posed by China-led economic order.
- Ladakh aggression forced India to go from a passive commercial withdrawal to an active economic decoupling from China.
Way forward
- The logic of strategic autonomy from China nudges India to look for strong security partnerships with the US, Europe, Japan and Australia.
- On the economic front, India is exploring various forms of collaboration with a broad group of nations that have a shared interest in developing trustworthy global supply chains.
Consider the question “Delineate the evolution of India’s approach towards the idea of strategic autonomy. How it differs from the past?”
Conclusion
Threats to either territorial integrity or economic prosperity are powerful enough on their own to compel drastic changes in any nation’s policies. Coming together, they promise to make strategic autonomy from an assertive China an enduring theme of India’s economic and foreign policies in the years ahead.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: MEIS, RODTEP Scheme
Mains level: Export promotion measures
The outlay for the RoDTEP scheme is expected to be “much higher” than the NITI Aayog’s much-curtailed estimate of Rs 10,000 crore a year.
Overt allocation
- The central government had envisaged an annual allocation of about Rs 50,000 crore under the RoDTEP scheme to make exports zero-rated.
Try this PYQ:
Q. Among the following, which one is the largest exporter of rice in the world in the last five years? (CSP 2019)
(a) China
(b) India
(c) Myanmar
(d) Vietnam
RoDTEP Scheme
- RoDTEP is a scheme for the Exporters to make Indian products cost-competitive and create a level playing field for them in the Global Market.
- It has replaced the current Merchandise Exports from India Scheme, which is not in compliance with WTO norms and rules.
- The new RoDTEP Scheme is fully WTO compliant scheme.
- It will reimburse all the taxes/duties/levies being charged at the Central/State/Local level which are not currently refunded under any of the existing schemes but are incurred at the manufacturing and distribution process.
Back2Basics: Merchandise Exports from India Scheme (MEIS)
- MEIS was launched with an objective to enhance the export of notified goods manufactured in a country.
- This scheme came into effect on 1 April 2015 through the Foreign Trade Policy and will be in existence till 2020.
- MEIS intends to incentivise exports of goods manufactured in India or produced in India.
- The incentives are for goods widely exported from India, industries producing or manufacturing such goods with a view to making Indian exports competitive.
- The MEIS covers almost 5000 goods notified for the purpose of the scheme.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: PVTGs
Mains level: Not Much
The COVID-19 pandemic has reached the Bondas, a PVTGs community residing in the hill ranges of Malkangiri district in Odisha.
Try this PYQ:
Consider the following statements about Particularly Vulnerable Tribal Groups (PVTGs) in India:
- PVTGs reside in 18 States and one Union Territory.
- A stagnant or declining population is one of the criteria for determining PVTG status.
- There are 95 PVTGs officially notified in the country so far.
- Irular and Konda Reddi tribes are included in the list of PVTGs.
Which of the statements given above are correct?(CSP 2019)
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 2 and 4
(d) 1, 3 and 4
Who are the Bondas?
- The Bondas are Munda ethnic group who live in the isolated hill regions of the Malkangiri district of southwestern Odisha near the junction of the three states of Odisha, Chhattisgarh, and Andhra Pradesh.
- They are a scheduled tribe of India and are also known as the Remo (meaning “people” in the Bonda language).
- The tribe is one of the oldest and most primitive in mainland India; their culture has changed little for more than a thousand years.
- Their isolation and known aggressiveness continue to preserve their culture despite the pressures of an expanding Indian population.
Back2Basics: Particularly Vulnerable Tribal Groups (PVTGs)
- There are certain tribal communities who have declining or stagnant population, low level of literacy, pre-agricultural level of technology and are economically backward.
- They generally inhabit remote localities having poor infrastructure and administrative support.
- These groups are among the most vulnerable section of our society as they are few in numbers, have not attained any significant level of social and economic development.
- 75 such groups have been identified and categorized as Particularly Vulnerable Tribal Groups (PVTGs).
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: NFS Act
Mains level: Assurance of Food Security
The Department of Food &Public Distribution has issued directions to States/UTs to include all eligible disabled persons under the National Food Security (NFS) Act 2013.
Try this question:
Q.In the ongoing crisis, maintaining the level of food security has become one of the most essential needs. In light of the above statement, critically examine the priority areas for maintaining food security in the country. Suggest measures to make accessibility and availability of food easier for all.
National Food Security (NFS) Act
- The NFS Act, 2013 aims to provide subsidized food grains to approximately two-thirds of India’s 1.2 billion people.
- It was signed into law on 12 September 2013, retroactive to 5 July 2013.
- It converts into legal entitlements for existing food security programmes of the GoI.
- It includes the Midday Meal Scheme, Integrated Child Development Services (ICDS) scheme and the Public Distribution System (PDS).
- Further, the NFSA 2013 recognizes maternity entitlements.
- The Midday Meal Scheme and the ICDS are universal in nature whereas the PDS will reach about two-thirds of the population (75% in rural areas and 50% in urban areas).
- Under the provisions of the bill, beneficiaries of the PDS are entitled to 5 kilograms per person per month of cereals at the following prices:
- Rice at ₹3 per kg
- Wheat at ₹2 per kg
- Coarse grains (millet) at ₹1 per kg.
- Pregnant women, lactating mothers, and certain categories of children are eligible for daily free cereals.
Implementation
- Section 38 of the Act mandates that the Central Government may from time to time give directions to the State Governments for effective implementation of the provisions of the Act.
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Note4Students
From UPSC perspective, the following things are important :
Prelims level: Brahmaputra Ropeway
Mains level: Not Much
India’s ‘longest’ river ropeway across the Brahmaputra River was unveiled in Guwahati.
Navigate to this page for more readings on Brahmaputra River systems:
Brahmaputra Ropeway
- The 1.82 km bi-cable jig-back ropeway connects the southern bank of the Brahmaputra and a hillock behind the Doul Govinda temple in North Guwahati on the other.
- It passes over the mid-river Peacock Island that houses Umananda, a medieval Shiva temple.
- It thus cuts travel time between the two banks to 8 minutes.
- The current travel options between the two banks are by ferry (30 minutes or more, depending on current and season) or by road through a bridge that usually takes over an hour in the traffic.
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