A first step — on NDA govt. Ayushman Bharat :-
The NDA government’s scheme to provide health cover of ₹5 lakh per year to 10 crore poor and vulnerable families through the Ayushman Bharat-National Health Protection Mission has taken a step forward with the Union Cabinet approving the modalities of its implementation.
What needs to be done to get things right ?
- For a start, the apex council that will steer the programme and the governing board to operationalize it in partnership with the States need to be set up.
- The States, which have a statutory responsibility for provision of health care, have to act quickly and form dedicated agencies to run the scheme.
- Since the NHPM represents the foundation for a universal health coverage system that should eventually cover all Indians, it needs to be given a sound legal basis, ideally through a separate law or on the lines of legislation governing the rights to food and information. Such legislation would strengthen entitlement to care, which is vital to the scheme’s success & It will also enable much-needed regulatory control over pricing of hospital-based treatments.
- The initial norms set for availing benefits under the NHPM, which subsumes earlier health assurance schemes, appear to make the inclusion of vulnerable groups such as senior citizens, women and children contingent on families meeting other criteria, except in the case of Scheduled Caste and Scheduled Tribe households. The government should take the bold step of including these groups universally.
Universal Health Coverage Definition by WHO :-
Universal health coverage is defined by the WHO as a state when “all people obtain the health services they need without suffering financial hardship when paying for them”.
With its endorsement of the Sustainable Development Goals for 2030, India will have to constantly raise its ambition in coming years which underscores the importance of :-
- Raising core budgetary spending every year.
- Need to pay attention to social determinants of health like Affordable housing, planned urban development, pollution control and road safety which will help for reducing the public health burden.
- Govt has paid a little attention towards social determinants of health as quality of life erodes even with the steady or growing economic growth.
- NITI Aayog advocated a State-specific approach rather than a grand national health system to expand access.
Since Ayushman Bharat – NHPS have a national character with States playing a crucial role in its implementation, and beneficiaries being able to port the service anywhere. It is a challenging task to make all this a reality, and the government will have to work hard to put it in place.
Tibet is not a card :-
- The government’s bid to ease tensions with China has been met with some criticism, particularly over a leaked memo to officials telling them to stay away from events that commemorate the 60th anniversary of the Dalai Lama’s 1959 flight to India. This has led to the cancellation of several public events related to Tibet.
- The biggest mistake is Government using Tibetan refugees in India as a card in its relations with China.
Ground Realities :-
India – China ties have deteriorated on several occasions :-
- Border incursions, including the standoff at the part of Doklam claimed by Bhutan.
- India’s strategic shift in line with the U.S.’s Indo-Pacific pivot that targets China.
- China’s ‘deep-pocket’ inroads into South Asia
- Differences on the international stage, including over the Nuclear Suppliers Group membership and terror designations to Masood Azhar.
So it is not simple as it looks like that India-China ties will improve if India make the Tibetan community and its leader less visible.
Changes in Tibet :-
- The landscape of Tibet, now crisscrossed with railway lines, super-speed highways, tunnels and airports, has changed drastically in the past two decades.
- The Tibet Autonomous Region (TAR) now sees many more such engineering marvels and downtown Lhasa has all the trappings of a modern city.
- There’s an ongoing demographic shift in Tibet, with Beijing populating areas with majority ‘Han’ Chinese workers, encouraging mixed marriages, and mainstreaming Chinese culture into the region.
- At the same time, the outflow of refugees from Tibet has been curtailed by the Chinese authorities over the last decade, mainly by convincing Nepal to close a popular route.
Therefore, it is time to revise this so called “Tibet Card” policy with a thorough evaluation of the ground, from New Delhi to Beijing and Lhasa to Dharamshala.
Whereas the Tibetan Refugees, they are more cut off from developments in their homeland than ever before :-
- New generations of Tibetans born in India are brought up as exiles, without a real sense of what Tibet may actually be like, should they ever return.
- They also have a tenuous link to the host country itself.
- The government’s attitude towards giving them citizenship has been stern, although it lost its case in the Delhi High Court (Namgyal Dolkar v. Government of India) and must give citizenship to all Tibetan refugees born between 1950 and 1987, the cut-off year.
Therefore, It will be equally important to devise a mechanism for those born after 1987.
Future Leadership for Tibetans :-
- The Central Tibetan Administration (CTA), which is empowered to run affairs and is headed by Mr. Sangay is following a “five-50” path, to pursue talks with China in the next five years, while committing to a struggle for a more autonomous Tibet in the next 50 years.
- However, the past few years have seen a rise in the younger and more radical “Rangtsen” (freedom) groups that says they will settle for nothing short of an independent Tibet.
- Tibetan Youth Congress’s “Bharat Jagran Yatra”, with rallies in several cities across the country are “raising awareness for a free Tibet”.
- Possible talks between the Dalai Lama and the Chinese government that were dropped in 2010. Chinese President Xi Jinping, who has now secured his position for the foreseeable future, may well take a more proactive interest in the Tibet issue, which his father once discussed with the Dalai Lama.
What govt needs to do to get out of their “Tibet Card” idea ?
- The government needs a proactive policy that takes into account these new realities.
- There is an urgent need for community outreach, surveys and a referendum, if necessary, to map what the Tibetan community in India wants in its future.
- For those who want to make India a permanent home, especially those in the new generation, India must reconsider its citizenship laws.
- Above all, the Indian foreign policy establishment needs to stop seeing the Tibetan population in India as a strategic tool.