-
Abhay
Shukla, CEHAT
-
"Should
medicine ever fulfil its great ends, it must enter into the larger political
and social lifeof our time; it must indicate the barriers which obstruct the
normal completion of the life cycleand remove them. Should it ever come to
pass, Medicine, whatever it may then be, will become the common good of
all." -
Rudolf Virchow, c.1850
India is known to have poor health
indicators in the global context, even in comparison with many other developing
countries. However, we also bear the dubious distinction of being among the
more inequitous countries of the world, as far as health status of the poor
compared to the rich is concerned. This underscores the fact that there is a
tremendous burden of unnecessary morbidity and mortality, which is borne almost
entirely by the poor. Some striking facts in this regard are -
·
Infant mortality among the
economically lowest 20% of the population is 109, which is 2.5 times the IMR among
the top 20% population of the country.
·
Under-five mortality among the
economic bottom 20% of the population (bottom quintile) is 155, which is not
only unacceptably high but is also 2.8 times the U5MR of the top 20%
(top quintile).
·
Child mortality (1-5yrs age) among
children from the 'Low standard of living index' group is 3.9 times that for those
from the 'High standard of living index' group according to recent NFHS data
(IIPS, 2002). Every year, 2 million children under the age of five years
die in India, of largely preventable causes and mostly among the poor. If the
entire country were to achieve a better level of child health, for example the
child mortality levels of Kerala, then 16 lakh deaths of under-five children
would be avoided every year. This amounts to 4380 avoidable deaths every day,
which translates into three avoidable child deaths every minute.
·
Tribals, who account for only 8% of
India's population, bear the burden of 60% of malarial deaths in the
country.
Such gross inequalities are of
course morally unacceptable and are a serious social and economic issue. In
addition, such a situation may also be considered a gross violation of the rights of the deprived sections of society.
This becomes even more serious when viewed in the context of gross
disparities in access to health care -
·
The richest quintile of the
population, despite overall better health status, is six times more likely to access hospitalisation than the poorest
quintile. This actually means that the poor are unable to afford and access
hospitalisation in a large proportion of illness episodes, even when it is
required
·
The richest quintile have three times higher level of coverage for measles immunization
compared to the poorest quintile. Similarly, a mother from the richest 20% of
the population is 3.6 times more likely
to receive antenatal care from a medically trained person, compared to a mother
from the poorest 20%. The delivery of the richer mother is over six times more likely to be attended by a medically trained
person than the delivery of the poor mother.
·
As high of 82% of outpatient care is
accessed from the private sector, met almost entirely by out-of-pocket
expenses, which is again often unaffordable for the poor.
·
About three-fourths of spending on
health is made by households and only one-fourth by the government. This often
pushes the already vulnerable poor into indebtedness, and in over 40% of
hospitalisation episodes, the costs are met by either sale of assets or taking
loans.
·
The per capita public health
expenditure in India is abysmally low, below $5 annually. India has one of the
most privatized health systems in the world (only five countries on the globe
are worse off in this respect), effectively denying the poor access to even
basic health care.
The gist of these sample facts is
that the existing system of ‘leave it to the market’ effectively means ‘leave
health care for the rich and leave the poor to fend for themselves’.
One implication that emerges from
the above discussion is that the problem of large-scale ill health in India
should not be seen as primarily a technical-medical issue. The key requirement
is not newer medical technologies, more sophisticated vaccines or diagnostic
techniques. The fact that the prosperous sections of the population enjoy a
reasonably good health status implies that the
technical means to achieve good health do broadly exist in our country today
(though there is definitely a need to better adapt these to our country’s conditions
and traditions, and certain improved techniques might help in specific
contexts).
In fact, for the vast majority,
the key barriers to good health are not the lack of technology but poverty and
health system inequity. Poverty, a manifestation of social inequity, leads
to large sections of the population being denied adequate nutrition, clean
drinking water and sanitation, basic education, good quality housing and a
healthy local environment, which are all prerequisites for health. At the same
time, we have a highly inequitable health system which denies quality health
care to all those who cannot afford it (the fact that even those who can afford it do not always get
rational care is another important, but somewhat separate issue!). In this
paper, which is primarily addressed to those working in the health sector, we
will focus on the critical health system
issues, with a rights-based approach. Let us see how we can view this entire
situation from a rights based perspective.
Looking at the issue of health
under the equity lens, it becomes obvious that the massive burden of morbidity
and mortality suffered by the deprived majority is not just an unfortunate
accident. It constitutes the daily denial
of a healthy life, to crores of people, because of deep structural injustice,
within and beyond the health sector. This denial needs to be addressed in a
rights based framework, by systematically establishing the right of every
citizen of this country, to a healthy life. More specifically, health care can
no longer be viewed as just a technical issue to be left to the experts and
bureaucrats, an issue of charity to be dealt with by benevolent service
delivering institutions, or a commodity to be sold by private doctors and
hospitals. The role of all these
actors needs to be redefined and recast in a framework where every person,
including the most marginalized, is assured of basic health care and can demand and access this as a right.
It is clear that achieving a
decent standard of health for all requires a range of far reaching social,
economic, environmental and health system changes. There is a need to bring
about broad transformations both within and beyond the health care sector,
which would ensure an adequate standard of health for all. In other words, to
promote the Right to Health requires
action on two related fronts (WHO, 2002):
Promoting the Right to
underlying determinants of health
This involves working for the right to ‘the underlying
determinants of health, such as access to safe and potable water and adequate
sanitation, an adequate supply of safe food, nutrition and housing, healthy
occupational and environmental conditions, and access to health-related
education and information, including on sexual and reproductive health’ (WHO,
2002). Agencies engaged in the health sector cannot deal with most of these
issues on their own, though they need to highlight the need for better services
and conditions, and can advocate for improvements in these areas in a rights
based framework. Organisations working in the health sector should support and
ally with other agencies working directly in these areas, to help bring about
relevant improvements.
Promoting
the Right to Health Care
Given the gross inequities in
access to health care and inadequate state of health services today, one
important component of promoting the Right to Health would be to ensure access
to appropriate and good quality health care for all. This would
involve reorganisation, reorientation and redistribution of health care
resources on a societal scale. The responsibility
of taking forward this issue seems to lie primarily with agencies working in
the health sector, though efforts in this direction would surely be supported
by a broad spectrum of society.
In the remaining portion of this
paper, we will focus on the process of establishing the Right to health care
as a imminent task, to be taken up by organisations in the health sector within
the broader context of Right to Health outlined above.
We may view the justification for
this right at three levels - constitutional-legal, social- economic and as a
human right issue.
The right to life is recognised as a fundamental right in the
constitution (Article 21) and this right has been quoted in various judgements
as a basis for preventing avoidable disease producing conditions and to protect
health and life. The directive principles of the Indian
constitution include article 47, which specifies the duty of the state
in this regard:
47. Duty of the state to raise the level of nutrition
and the standard of living and to improve health:- The state shall regard the
raising of the level of nutrition and the standard of living of its people and
the improvement of public health as among its primary duties …
In an important judgement (Paschim Banga Khet Mazdoor Samity and others v. State of West Bengal
and another, 1996), the Supreme Court of India ruled that -
In a welfare state the primary duty of the Government
is to secure the welfare of the people. Providing adequate medical facilities
for the people is an essential part of the obligations undertaken by the
Government in a welfare state. … Article 21 imposes an obligation on the State
to safeguard the right to life of every person. … The Government hospitals run
by the State and the medical officers employed therein are duty bound to extend
medical assistance for preserving human life. Failure on the part of a Government hospital to provide timely medical
treatment to a person in need of such treatment results in a violation of his
right to life guaranteed under Article 21. (emphasis added)
Similarly in the cases Bandhua Mukti Morcha v. Union of India and others, 1982 concerning
bonded workers, the Supreme Court gave orders interpreting Article 21 as
mandating the right to medical facilities for the workers.
Basic social services are now being recognised as fundamental rights
with the 93rd amendment in the constitution accepting Education as a
fundamental right. Despite the controversy and problems regarding the actual
provisions of the Bill, it is now being accepted that essential social services
like education can be enshrined in the fundamental rights of the Constitution.
This forms an appropriate context to establish the right to health care as a
constitutionally recognised fundamental right.
It is now widely recognised that besides being a basic human right,
provision of adequate health care to a population is one of the essential
preconditions for sustained and equitable economic growth. The proponents of
'economic growth above all' may do well to heed the words of the Nobel Laureate
economist Amartya Sen:
'Among the different forms of intervention that can
contribute to the provision of social security, the role of health care
deserves forceful emphasis … A well developed system of public health is an
essential contribution to the fulfilment of social security objectives.
…we have every reason to pay full attention to the
importance of human capabilities also as
instruments for economic and social performance. … Basic education, good
health and other human attainments are not only directly valuable … these
capabilities can also help in generating economic success of a more standard
kind … (from India: Economic Development
and Social Opportunity by Jean Dreze and Amartya Sen)
The right to basic health care is recognised internationally as a human
right and India is a signatory to the International Covenant on Economic,
Social and Cultural Rights which states in its Article 12 -
The States Parties to the present Covenant recognise
the right of everyone to the enjoyment of the highest attainable standard of
physical and mental health… The steps to be taken…shall include those necessary
for …The creation of conditions which would assure to all medical service and
medical attention in the event of sickness.
Reference can be made to other
similar international conventions, wherein the Government of India has
committed itself to providing various services and conditions related to the
right to health, e.g. the Alma Ata declaration of ‘Health for all by 2000’. The National Human Rights Commission has also
concerned itself with the issue of 'Public health and human rights' with one of
the areas of discussion being 'Access to health care'. The time
has come to begin asking as to how these human rights related commitments and
concerns will be translated into action in a realistic, time-bound and
accountable framework.
The negative impact of
Globalisation-Liberalisation-Privatisation policies on various social sector
services, especially since the early 1990s has been widely experienced. With
the growing withdrawal of the state from the social sector and encouragement to
the private medical sector, raising the issue of health rights has become
extremely relevant today. The ongoing abdication of basic obligations by the
Public Health system needs to be countered by a strong movement to establish
Health rights. Only a determined effort to establish these rights can roll back
the trend of weakening the Public health system, and can provide a framework
for rejuvenation of this system with increased accountability.
Moving towards establishing the Right to Health Care is likely
to be a process with various phases. First let us see what could be the core content of this right in the first
phase, which could be achieved in the short to medium term.
In the context of the goal of 'Health
for All' and various Health Policy documents, an entire range of health care
services are supposed to be provided to all from village level to tertiary
hospital level. As of today these services are hardly being provided
adequately, regularly or of the required quality. Components of the public
health system to be ensured in a rights based framework include:
1. Adequate physical
infrastructure at various levels
2. Adequate
skilled humanpower in all health care facilities
3. Availability
of the complete range of specific services appropriate to the level
4. Availability
of all basic medications and supplies (also see below)
The expected infrastructure and
services need to be clearly identified and displayed at various levels and
converted into an enforceable right, with appropriate mechanisms to
functionalise this. For example, in a justiciable framework, basic medical
services especially at Primary and Secondary levels cannot be refused to anyone
– for example a PHC cannot express inability to perform a normal delivery or a
Rural hospital cannot refuse to perform an emergency caesarean section. In case the requisite service such as a
normal delivery is not provided by the public health facility when required,
one approach could be to allow the patient to take recourse to a private
hospital and receive free care, for which the hospital would receive time-bound
reimbursement of costs incurred, at standard rates. This would firstly constitute a strong pressure on the public
health system to perform better and deliver all services, and secondly, would
ensure that the patient receives the requisite care when required, without
incurring personal expenses. This
could form one of the steps towards accessing the right to health care.
Similarly
the state has an explicit obligation to maintain public health through a set of
preventive and promotive services and measures. These of course include
coverage by immunisation, antenatal care, and prevention, detection and
treatment of various communicable diseases. However, it should also encompass
the operation of epidemiological stations for each defined population unit (say
a block), organizing multi-level surveillance and providing a set of integrated
preventive services to all communities and individuals.
In summary, the movement to
establish the Right to Health Care aims to substantially strengthen,
reorient and make accountable the Public Health System. The ‘public’ has to
come back centre-stage in the Public Health System!
Although the right to health care is not a fundamental
right in India today, the right to life is. In keeping with this ‘Emergency
Medical Care’ in situations where it is lifesaving, is the right of every citizen.
No doctor or hospital, including those in
the private sector, can refuse minimum essential first aid and medical care
to a citizen in times of emergency, irrespective of the person’s ability to pay
for it. The Supreme Court judgement quoted above (Paschim Banga Khet Mazdoor Samity and others v. State of West Bengal
and another, 1996), directly relates to this right and clear norms for
emergency care need to be laid down if this right is to be effectively
implemented. As a parallel, we can look at the constitutional amendments
enacted in South Africa, wherein the Right to Emergency Medical care has been
made a fundamental right.
At the same time there is an
urgent need for a comprehensive legislation to regulate qualification of
doctors, required infrastructure, investigation and treatment procedures
especially in the private medical sector. Standard guidelines for
investigations, therapy and surgical decision making need to be adopted and
followed, combined with legal restrictions on common medical malpractices.
Maintaining complete patient records, notification of specific diseases and
observing a ceiling on fees also needs to be observed by the private medical
sector. The Govt. of Maharashtra is in the process of enacting a modified act
to address many of these issues, and the National Health Policy 2002 stipulates
the enactment of suitable regulations for regulation of minimum standards in
the private medical sector in the entire country by the year 2003. This would
include statutory guidelines for the conduct of clinical practice and delivery
of medical services. There is a need to shape such social regulation of this
large medical sector within the larger, integrated framework of Right to health
care.
Attaining this right would consist
of two components:
1.
Availability of certain basic medications free of cost
through the public health system (see above)
2.
A National Essential Drug Policy ensuring the production and
availability of an entire range of essential drugs at affordable prices
The Union as well as state Governments need to publish comprehensive
lists of essential drugs for their areas. A ceiling on the prices of these
drugs must be decided and scrupulously adhered to, with production quotas and a
strict ban on irrational combinations and unnecessary additives to these drugs.
The entire
range of treatment and diagnosis related information should be made available
to every patient in either private or public medical facility. Every patient
has a right to information regarding staff qualifications, fees and facilities
for any medical centre even before they decide to take treatment from the
centre. Information about the likely risks and side effects of all major procedures
can be made available in a standard format to patients. Information regarding
various public health services which people have a right to demand at all
levels should be displayed and disseminated. This should include information
about complaint mechanisms and for redressal of illegal charging by public
health personnel.
Superseding the CPA, a much more
patient-friendly grievance redressal mechanism needs to be made functional,
with technical guidance and legal support being made available to all those who
approach this system. This would provide an effective check on various forms of
malpractice. In case the services mandated under this right are not given by a
particular facility, the complainant need not take recourse to lengthy legal
procedures. Rather, the grievance redressal mechanism with participation of
consumer and community representatives should be empowered to take prompt,
effective and exemplary action.
Keeping in
mind the devolution of powers to the Panchayati Raj system, we need to propose
an effective system of people's monitoring of public health services which
would be organised at the village, block and district levels. Community monitoring of health services would
significantly increase the accountability of these services and will lead to
greater people's involvement in the process of implementing them. The Union
Ministry of Health and Family Welfare, with support from WHO, has implemented
an innovative pilot project for 'Empowering the rural poor for better health'
in six talukas of the country. Taking this and various other experiments into
account, a basic framework for such monitoring needs to be developed.
It is obvious that the establishment of any system of rights
is relevant only if it benefits the most vulnerable or deprived sections of the
population, and addresses the needs of people facing situations where their
basic rights are likely to be denied. All the above types of provisions need to
be implemented keeping in view some of the following key rights (an
illustrative, not exhaustive list):
·
Women’s Right to Health Care, including provision of
services related to both reproductive and non-reproductive health problems
specific to women, and appropriate general health services for women;
·
Children’s Right to Health Care, with a focus on nutritional
supplementation, control of infectious diseases in childhood and reduction in infant
and child mortality;
·
Health Rights of HIV-AIDS affected persons, including
facilities for detection, counselling, non-discriminatory treatment and access
to anti-retroviral drugs;
·
Right to Mental health care, with a focus on strengthening
primary mental health care, non-discriminatory quality treatment and community
based rehabilitation systems;
·
Right to Health Care for unorganised workers, who lack
effective health care coverage and face a range of occupational hazards, with a
clear liability on employers;
·
Right to Health Care for urban deprived communities,
including putting in place Urban primary health care systems and effective
referral mechanisms;
·
Health rights in conflict situations, where due to communal
or other forms of violence persons from particular communities may be denied
access to basic health services or may be discriminated against;
·
Health rights of communities facing displacement or
involuntary resettlement, depriving them of their customary environment and
livelihood, and placing them in often hostile new surroundings which may
include threats to health and poorer access to health care
This list may be further expanded
to include the elderly, disabled persons, migrants and other categories of
vulnerable people. Any system of health rights would need to explicitly address
the special health needs of such groups, which would require provision of
special services and forms of protection against discrimination.
Some of the possible areas of
activity of a broad coalition like Jan Swasthya Abhiyan, which could develop a
campaign on the issue of Right to Health Care, are suggested below.
While some health activists and
groups have mooted the concept of the Right to Health Care, it is an idea,
which is yet to be widely discussed and accepted in our country. One of the key
tasks in the immediate future is to generate discussion at the broadest
possible level about this right. Groups to be involved in such a debate include
health policy makers, medical and public health academics, private medical
professionals, people's organisations, women’s groups, organisations
representing or working with various vulnerable groups, various segments of the
NGO sector including both health related and non-health NGOs and trade unions
of health care personnel. It is obvious that the viewpoints of various social
groups and actors may be greatly divergent on this issue. However, the very
process of discussing and debating the issue gives it a primary legitimacy,
which then needs to be built upon. This becomes a basis for generating a
continuously widening consensus about the basic justification, content and
implementation model for the Right to Health Care.
There is valuable international
experience available about mandating the Right to Health or Health Care. These
experiences need to be collated, and analysed with the Indian context in mind.
Especially legislation and provisions made in developing countries are of value
in this respect.
Cuba with a socialist constitution
accords the right to health to its citizens, according it a status equivalent
to civil and political rights.
South Africa, after the overthrow
of apartheid, in Article 27 of its constitution has specified certain
provisions relevant to this right. This includes mandating the right to access
to health care services, specifying that the state must take reasonable
legislative measures to achieve realisation of this right, and declaring that
no one may be refused emergency medical treatment. From another end, we have a
new system of Universal health care access in Thailand whose features need to
be studied and discussed as relevant to the Indian context.
Similarly, there has been an
entire process of developing the concept of right to health and health care in
the international human rights discourse. Various United Nations health rights
instruments refer to health related rights. The UN International Covenant on
Economic, Social and Cultural Rights (ICESCR), UN Convention on Rights of the
Child (CRC) and the UN Convention on the Elimination of All Forms of
Discrimination Against Women (CEDAW) are some such significant conventions, in
which India is a signatory.
Given this background, one of the
critical tasks ahead of us is to make an in-depth study of these experiences
and utilise this for developing the judicial form and implementation-related
content of the Right to Health Care in the Indian situation.
One way of developing such a
consensus and mobilising various social organisations is to organise regional
public hearings, on the issue of Right to Health Care. The NHRC could be a
partner or ‘mediator’ for such public hearings, which could involve
presentation of cases of Denial of health care. With the involvement of State
Public health officials and policy makers in such hearings, the stage could be
set for addressing the core issues, demanding accountability and putting in
place monitoring mechanisms to ensure basic health rights.
One of the crucial issues in furthering
this campaign is the development of a model for implementing this Right. This
needs to be done, keeping in mind the specificities of the Indian health care
system, judicial framework (including the fact that Health is a state subject),
socio-economic situation including major class, caste and gender disparities
and recent processes such as the positive and negative lessons of the impending
93rd Constitutional amendment. Considerable groundwork and
consultation is required to develop a model, which would take into account
legal, operational and human rights considerations and form the basis for
practical implementation of this right.
Next, there is a need to take
appropriate legal action to establish this basic right. Submitting a National
petition on Right to Health Care to the National Human Rights Commission, with
extensively documented cases of denial of health care could be a logical first
step. Filing of specific PILs, focussed on key health rights may also be
necessary to exert legal pressure and to provide leverage to the campaign.
Political lobbying for passage of state level legislations, such as Public
Health Acts, may be essential to actually establish legal entitlements, which
can be activated by any ordinary citizen.
Finally, we need to move towards the medium-term objective
of establishing Health Care as a Fundamental Right in the Indian Constitution.
This would be a prolonged and challenging process, and would involve political
mobilisation and influencing public and political opinion on a large scale,
besides formulating an appropriate bill based on legal inputs. This would need
to be complemented by State level legislations and effective strengthening of
the Public health system. Putting in place effective monitoring mechanisms, and
widespread public awareness about the entitlements would be essential for this
right to become operational in any meaningful form. One conception of the minimum content of the fundamental right to health
care is outlined in the accompanying box.
Proposed
minimum content of the fundamental right to health care
1.
Making the right to health care a
legally enforceable entitlement by legal enactment
2.
A national health policy with a
detailed plan and timetable for realization of the core right to health care
3.
Developing essential public
health infrastructure required for health care; investing sufficient resources
in health and allocating these funds in a cost-effective and fair manner
4.
Providing basic health services
to all communities and persons; focusing on equity so as to improve the health
status of poor and neglected communities and regions
5.
Adopting a comprehensive strategy
based on a gender perspective so as to overcome inequalities in women’s access
to health facilities
6.
Adopting measures to identify,
monitor, control and prevent the transmission of major epidemic and endemic
diseases
7.
Making reproductive health and
family planning information and services available to all persons and couples
without any form of coercion
8. Implementing an essential drug policy
(Adapted from Audrey R. Chapman, The Minimum Core Content of the Right
to Health)
While the course and outcome of all our efforts would depend
on the much larger political environment, the slogans of ‘Right to Health’ and
‘Right to Health Care’ should continue to be the rallying-cry on our banner.
Whether we are confronting the State or are trying to envisage models for the
future and shape people’s counter-hegemony, the vision of the Right to Health
and Health Care should form one of the components of our dream for a more just
and humane society.
(This article is an updated version of a note prepared by Dr. Abhay
Shukla of CEHAT, for the Seminar on 'Right to Health Care' organised on 3-4
January 2003 during the Asian Social Forum at Hyderabad. Several sections of
this article are adapted from Abhay’s article 'Right to health care' published
in Health Action, May 2001)
While trying to achieve these specific rights in the first phase, our
overall goal should be to move towards a system where every citizen has assured
access to basic health care, irrespective of capacity to pay. A number of
countries in the world have made provisions in this direction, ranging from the
Canadian system of Universal health care and NHS in Britain to the Cuban system
of health care for every citizen. In the Indian context, while the right to
health care needs to be enshrined in the Constitution as a fundamental right,
there is a need to develop a complementary system of Universal access to health
care.
The existing massive private medical sector in India,
which commands over three fourths of the doctors and provides a similar
proportion of outpatient care, needs to be addressed and tackled in any system
to provide Universal health care coverage. One possible scenario to make this
right functional could be a system of Universal social health insurance. The
services could be given by a combination of a significantly strengthened and
community-monitored public health system, along with some publicly regulated
and financed private providers, under a single umbrella. The entire system would
be based on public financing and cross-subsidy, with free services to the
majority population of rural and urban working people including vulnerable
sections, and affordable premium amounts (which could be integrated with the
taxation system) for higher income groups.
One key aspect would be that this should be a Universal system (not targeted),
which would ensure coverage of the entire population and also retain a strong
internal demand for good quality services. (Of course, certain very affluent
sections may choose to pay their share of taxation / premium and yet opt out
and access private providers.) Another issue is that there should be no fees or nominal fees at the time of actual giving of services. Finally,
the patient should be assured of a range of services with minimum standards,
whether given from the public health system or publicly financed and regulated
private providers. The entire system could be managed in a decentralised
manner, with consumer’s monitoring of quality and accessibility of services.
This entire model would of course imply a significantly
higher public expenditure on health services. However, with decentralised
management and a focus on rational therapy, it has been estimated that it
should be possible to organise the most basic elements of such a system by
devoting about 3% of the GNP towards public health care to start with. This
should then be progressively raised to the level of 5% of GNP spent on
Public health to give a full range of services to all. This level of funds
could be partly raised by appropriate taxation of unhealthy industries,
reallocations within the health sector (including reorganising existing schemes
like ESI) and ending all subsidisation of the private medical sector. This of
course needs to be combined with changed budgetary priorities and higher
overall allocation for the health sector. Incidentally, the new National Health
Policy claims on paper the intention to more than double the financial
allocation for the public health system and bring it to the level of 2% of the
GDP, and to increase utilisation of public health facilities to above 75% by
the end of this decade. This admirable yet vague intention needs to be
converted into concrete action by means of strong and sustained pressure from
various sections of civil society, coupled with concrete proposals to
functionalise universal access to health care.
In this context, ensuring the Right to Health Care for
all is not an unrealistic scenario, but has become an imperative for a nation,
which as the 'world’s largest democracy' claims to accord certain basic rights
to its citizens, including the right to life in its broadest sense.
******