Most Affordable IAS Coaching in India  

28 Mar 2023 : The Hindu Editorial Analysis

Editorial 1: A shared G20 vision for the ocean commons

Introduction:

  • The G20 countries together account for around 45% of the world’s coastlines and over 21% of the exclusive economic zones (EEZs). The oceans are reservoirs of global biodiversity, critical regulators of the global weather and climate, and support the economic well-being of billions of people in coastal areas.

 

A host of initiatives

  • The Government of India has launched bold initiatives to promote the development of a blue economy.
  1. Sagarmala initiative promotes port-led development. The Shipbuilding Financial Assistance Policy encourages domestic ship-building.
  2. Pradhan Mantri Matsya Sampada Yojana is actively engendering a ‘blue revolution’ through sustainable and responsible development of the fisheries sector.
  3. Sagar Manthan dashboard tracks vessels in real-time.
  4. Deep Ocean Mission explores deep-sea resources in the EEZ and continental shelf as well as development of technology for harnessing them.
  5. India adopted the Coastal Regulation Zone (CRZ) notification to classify and better manage coastal regions and conserve ecologically sensitive coastal and marine areas including ecosystems.
  6. As the host of the World Environment Day in 2018, Mr. Modi gave a clarion call to eliminate single-use plastic.
  7. In 2022, the global community rallied together for a multilateral treaty on addressing plastic pollution. The same year, India introduced an amendment to the Plastic Waste Management Rules banning select single-use plastic items and introduced policies for extended producer responsibility (EPR) in waste management in order to combat plastic pollution, including in the marine environment.

 

Blue economy and role of G20:

  • The term includes not only ocean-dependent economic development, but also inclusive social development and environmental and ecological security. Recognising the contribution of the ocean economy for sustainable development,
  • From this position of strength, as part of the India’s G20 Presidency, the blue economy is articulated as a key priority area under the Environment and Climate Sustainability Working Group. The aim is to promote adoption of high-level principles that guide sustainable and equitable economic development through the ocean and its resources, while simultaneously addressing climate change and other environmental challenges.
  • This approach is consistent with Mr. Modi’s call for the global adoption of ‘Lifestyle for the Environment’ or Mission LiFE that promotes mindful utilisation over mindless consumption patterns.
  • Over the last decade, the G20 forum has discussed some specific ocean-related issues. These include:
  1. G20 Action Plan on Marine Litter
  2. Osaka Blue Ocean Vision
  3. Coral Research and Development Accelerator Platform

 

  • Last year, holistic discussions on blue economy were initiated at the Ocean 20 launch in Bali. India’s commitment to prioritising oceans and the blue economy under its presidency would ensure continued discussions on this crucial subject and pave the way for future G20 presidencies.

 

Problems faced by oceans:

  • We must also recognise, however, that the ambitious efforts by countries to expand their blue economies are being threatened by factors that also pose significant threats to the ocean, coastal and marine ecosystems, and biodiversity. These include:
  1. intensifying extreme weather events
  2. ocean acidification
  3. sea level rise
  4. Growing marine pollution
  5. over-extraction of resources
  6. unplanned urbanisation
  • The inherent inter-connectedness of oceans implies that activities occurring in one part of the world could have ripple effects across the globe. Therefore, the responsibility of their protection, conservation and sustainable utilisation lies with all nations. Since the blue economy involves a range of stakeholders and affects several other sectors of the national economy, effective and efficient ocean and blue economy governance also presents a significant challenge.

 

Way forward: An important role

  • In this context, India’s G20 presidency would play an important role in promoting individual and collective actions to facilitate the transition towards a sustainable blue economy. Several G20 members have released their strategies for developing and/or expanding their blue economy.
  • This forum presents an excellent opportunity to build an effective communication with all stakeholders to share best practices, foster collaborations for advancements in science and technology, promote public-private partnerships, and create novel blue finance mechanisms.
  • The outcomes of this forum must further inform other international negotiations under the
  1. United Nations Framework Convention on Climate Change (UNFCCC)
  2. Convention on Biological Diversity (UN- CBD)
  3. Intergovernmental Negotiating Committee on Plastic Pollution (INCPP)
  4. United Nations Convention on the Law of the Sea (UNCLOS) etc

 

Conclusion:

  • The stewardship of oceans is an investment that will sustain future generations. The spirit of ‘One Earth, One Family, One Future’ must unite the global community for the well-being of our ocean commons.

Editorial 2: The cost of insurance-based funding

Context:

  • Tamil Nadu public health model is iconic. It has ensured equity in the delivery of health care, led to big improvements in maternal and infant mortality and universal immunisation coverage, and led to a low total fertility rate compared to the all-India average.
  • There has been a change in funding for healthcare in the last decade. The funding mix varies from grants from the National Health Mission to the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS). In this article, we look at the gains and the loss due to funding through insurance companies.

 

Benefits of decentralisation

  • The central gain is the decentralisation of medical and healthcare administration. Powers have been substantially transferred to the heads of the department to purchase drugs. This has cut red tape. Decentralisation has empowered individual departments to prioritise their needs and hasten decisions in patient care in accordance with evidence-based medical advancement.
  • On the flip side, every department in the medical college has become an individual establishment. These departments compete with one another to maximise profit and minimise losses. As a result, secondary and tertiary healthcare systems are viewing patients and their ailments through the prism of indemnity.
  • Negotiations with insurance companies have become cumbersome exercises for the already overworked patient care teams in public sector hospitals. Administrative delays by insurance companies have shifted the focus of hospitals from patient care, teaching and research to claiming money from companies.

 

Loss of compassion

  • Medicine is neither an absolute science nor a commodity but an art that needs passion and compassion. In the last 50 years we were able to achieve good indicators in health not because of administrators alone, but by ensuring that doctors came from different socio-economic strata and by empowering them with good pay and providing opportunities for post-graduation and super specialisation.
  • They, in turn, infused the concept of modern medicine among the rural people of Tamil Nadu and made it a sustainable success. Mere profit-loss calculation and treatment of public health as a health industry will lead to an erosion of compassion among health professionals.
  • In Tamil Nadu, between 2012 and 2021, ₹7,783 crore was allotted in the CMCHIS to insurance companies. Of this, only ₹2,895 crore has been claimed by government hospitals. The remaining has flowed to private hospitals. This disproportionate ‘diversion’ of funds will further shrink funding to public hospitals.

 

Towards a UHC:

  • Universal Health Coverage (UHC) is widely discussed worldwide as an essential component of the development agenda. The outbreak of Covid-19 has necessitated the need for universal health coverage as the health systems failed miserably across the globe during those times. Considering the importance of UHC, the United Nations declared 12th December as International Universal Health Coverage Day (UHC Day) in 2017.
  • The United Nations defines UHC as “everyone, everywhere should have access to the health services they need without risk of financial hardship.” Sustainable Development Goals target 3.8 (“Achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all”) also focuses on achieving universal health coverage.

 

Ayushman Bharat-PMJAY:

  • PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government. Launched in February 2018, it offers a sum insured of Rs.5 lakh per family for secondary care (which doesn’t involve a super specialist) as well as tertiary care (which involves a super specialist).
  • Under PMJAY, cashless and paperless access to services are provided to the beneficiaries at the point of service, that is, empanelled hospitals. Health Benefit Packages covers surgery, medical and day care treatments, cost of medicines and diagnostics.
  • This is an entitlement-based scheme that targets the beneficiaries as identified by latest Socio-Economic Caste Census (SECC- 2011) data.
  • The funding for the centrally sponsored scheme is
  1. 60:40 for all states and UTs with their own legislature
  2. 90:10 in Northeast states and Jammu and Kashmir, Himachal and Uttarakhand
  3. 100% Central funding for UTs without legislature.
  • The National Health Authority (NHA) has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PM-JAY in alliance with state governments. The State Health Agency (SHA) is the apex body of the State Government responsible for the implementation of AB PM-JAY in the State.

 

Conclusion:

  • Tamil Nadu has had a unique and robust policy framework that can work well in tandem with PMJAY and other central healthcare schemes, with a sared goal of achieving universal health coverage. Tamil Nadu model should be followed by other states lagging behind in public healthcare.