A Democrat’s view :
Growing Health Inequalities
Trends of Privatising Health Services in Andhra Pradesh
- N. Purendra Prasad, Professor at the department of Sociology, University of
The economic reforms in the
post-1990s significantly resulted in
heightened inequality among
different classes, castes and
genders. Two recent reports
substantiate the growing
inequalities in India. One, India
Exclusion Report 2016 which
examined 25 years of India’s
economic liberalization indicated
that as India’s economy grew
rapidly, the inequality between the
rich and poor increased, the
number of landless farmers
increased and employment
generation was lowest in 2015.
The report further said, the high
growth led to 12-fold increase in
wealth of the richest 10% people
since 2000 while for the poorest
10% the income jumped just three
times and the reason was dismal
new job creation. Second, a
research paper “Indian Income
Inequality 1922-2014: From British
Raj to Billionaire Raj” by Thomas
Piketty and Lucas Chancel
indicated that the share of national
income accruing to the top 1%
income earners is not at its
highest level since the creation of
Indian Income Tax Act of 1922.
The top 1% of earners captured
less than 21% of total income in
the late 1930s, before dropping to
6% in the early 1980s and rising
to 22% today. Thus the authors
concluded that income inequality
in India is at its highest level since
1922.
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Ill-health can be both a cause
and a consequence of poverty has
long been acknowledged and
widely documented in the health
literature. This inter-linkage has
been reopened for discussion
recently because there is an
increasing recognition of the
devastating effect of illnesses on
the capacity of the labouring poor
to work, and the high cost of
treatment which is causing further
impoverishment (Purendra Prasad
2018). In the recent poverty line
debates in India, the question
raised was how do these 35 crore
people survive on Rs 32 per person
per day in urban areas and Rs 26
per person per day in rural areas?
Similarly, the national commission
for enterprises in the unorganised
sector (NCEUS) data indicated
that 79% of workers in the
unorganised sector lived on an
income of less than Rs 20 a day
(Yadav A, 2014). The pertinent
question here, what do they do in
contingencies of illness, old age
and death? And how do they
protect themselves from slipping
into further poverty due to ill-
health? This paper provides a
discussion on the process how
public health sector got weakened
and privatization strengthened in
India in the section one. Section
two substantiates how the state of
Andhra Pradesh carries forward
the neo-liberal reforms in health
sector thus resulting in increased
health inequalities.
Hyderabad.
Section I
Government Health Sector :
Government health services
have gradually declined, public
investments have come down and
health care costs for indivi