Health Must Become a Political Priority

Manisha (name changed) has been living with a medical condition for more than 10 years. It made its presence felt after the birth of her third child. Manisha lives in the New Seemapuri area of Northeast Delhi and visited the GTB Hospital, where doctors told her the treatment procedure would cost Rs 50,000, as the hospital would need to charge for a device that must be implanted in her body.

Manisha is divorced, and has no ration card or pension. She ekes out a livelihood by begging outside a temple. She has received no financial help in securing treatment, despite visits from workers of several non-governmental organisations. She continues to live with the illness.

Samir (name changed), a migrant worker in Delhi, was fatally injured in an accident. His family was unable to get an ambulance and had to borrow Rs 27,000 to hire a private one to carry his body back to their village in Uttar Pradesh. The debt has become an added burden on his already struggling family.

The struggles of Manisha and Samir are not isolated. They are stark symptoms of a healthcare system in India that remains broken for millions. Manisha’s story reflects the experience of many women and girls in New Seemapuri, while Samir’s case shows how poverty can turn a medical emergency into a death sentence. How can someone who is unsure of getting two meals a day afford Rs. 50,000 for treatment? The question casts a long shadow over the nation’s healthcare system.

At the ground level, India’s health system forces the most vulnerable to pay out of pocket, pushing millions into poverty each year. People are often compelled to take loans for treatment. Those who cannot borrow are compelled to pay interest to access medical care. Regional disparities persist, with states like Kerala and Tamil Nadu faring far better than Bihar, Uttar Pradesh, and Jharkhand. In Delhi, the state government has failed to ensure universal access to public healthcare. Government hospitals and primary health centres suffer from overcrowding, a shortage of medicines, and poor sanitation. In the peak summer months of May and June, many government facilities don’t even have working fans.

Mental healthcare is another neglected area. Many patients do not receive the full course of medication from public hospitals and are forced to buy expensive medicines out of pocket, which they often cannot afford and have to then do without. Mental health services remain underfunded and stigmatised. Nationwide, patients pay for nearly 70 to 80% of healthcare expenses themselves, creating enormous financial stress. Even with schemes like Ayushman Bharat, many treatments for conditions like cancer and chronic illnesses remain unaffordable.

The government must expand the public healthcare system by establishing more primary health centres, hiring better staff, and ensuring all basic services are available. It should expand health insurance coverage to reduce out-of-pocket expenses and improve rural healthcare infrastructure. Ambulances should be available for all patients, including to transport deceased individuals. Although initiatives like Ayushman Bharat and the National Health Mission have made progress, they still suffer from underfunding, inequality, and inefficiency. Without systemic reform, India’s healthcare system will continue to fall short of meeting the needs of its vast population.

An increased healthcare budget could transform the lives of vulnerable and middle-class Indians alike. Despite Article 47 of the constitution directing the state to improve public health and nutrition, healthcare is not recognised as a fundamental right in India. The Directive Principles of State Policy are not legally enforceable like fundamental rights such as equality or free speech. In the absence of specific legislation, people cannot sue the government for failing to provide adequate care.

In countries like Brazil, healthcare is a constitutional right with free, universal access. The United Kingdom’s tax-funded healthcare system is free at the point of use. While these are higher-income nations, the principle of legislating healthcare as a right remains vital for India. Here, healthcare is not an enforceable right but a welfare policy. India must adopt stronger legislation, increase funding, and ensure better governance. These steps would compel governments to expand budgets, build infrastructure, reduce out-of-pocket expenses, which are a major cause of poverty, and improve legal accountability for denial of care.

Health must be treated as a political priority. The government must also meet critical infrastructure needs, such as maintaining reliable medicine supply chains. Civil society organisations must come together to demand that healthcare be made a justiciable right and to push for greater accountability and transparency in public health budgeting.

Until health becomes a fundamental right, backed by adequate resources and unrelenting accountability, millions of Indians like Manisha and Samir will remain unheard, their lives prematurely cut short by a system that continues to fail them.

Aysha is the convener of the Right to Food Campaign.

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