Health Care in UCPN-Maoist's Manifesto

My Scoring: (Please see my earlier blog for the scoring system)
- Relevance: 3
- Coherence: 2
- Practical Achievability: 1

Declarations on Health Care in UCPN-Maoist's Manifesto: (My translation from Nepali)
Access to health care will be established as fundamental right and free basic health care will be provided to all Nepali citizens. People of Karnali and similar other backward districts, marginalized and endangered ethnic groups, children below 15 years, elders above 70 years, people below the poverty line, individuals who have been injured or disabled during their involvement in people's war or other political struggles will be provided all types of health care for free and all women will be provided free maternity-related health care. All Nepalis will be insured for 50 major illnesses. Although World Health Organization recommends 2.3 health workers for every 1000 population, we have only 0.31 health workers for every 1000 population; especial focus will be placed to bridge this gap. When producing health care workers, appropriate priority will also be placed in producing health workers related to Ayurveda, Homeopathy, Yunai, Acupuncture, Acupressure, Naturopathy and Yoga. At least one health care facility will be established in each VDC and "One VDC one doctor" production will be given especial priority. Especial facilities will be arranged for doctors serving villages and remote areas. Mental health care will be integrated with health care. To ensure access of general population to mental health services, it will be considered part of basic health care. Discrimination, violence, social exclusion for individuals with mental illnesses will be considered crime, and legal equity and secure environment will be created for those with mental illnesses. Also including the private sector, modern fully-equipped hospitals will be established to attract foreigners for health care and to discourage Nepalis from going overseas for health care.        

My Comments:
There's a repetition of many of the issues we had already discussed in other parties' manifestos. I will very quickly brush through the document. 

They commit to ensuring access to everyone and emphasize priorities to the most vulnerable ones which is very welcome. But they put out the candy of "free." As I had mentioned earlier, there can be no free health care. It is very naive (and damaging) to talk about "free" health care; it raises false expectations in people. The document has used this populist tool liberally. 

For universal insurance they pick "50 major illnesses." How did they come up with this number? The main question is, can you ever pick illnesses that you want to insure? The relevance of tuberculosis for someone dying of cancer versus a young laborer, the sole breadwinner in family, is entirely different. It is naive to think that you can pick diseases to ensure a fair health care system. 

UCPN-Maoists also take a dip in the mud of alternative medicine (I have already discussed about the inherent problems with this fascination in the comments of MJFN's manifesto). 

"One VDC one doctor": It might be a thing that could be discussed during production of manpower but is wasteful if that is their plan of distribution of doctors. It is completely wasteful sending manpower that requires such long training to meet the local health care needs. We have to send health manpower commensurate with the health care needs. It might be rather damaging if we get indulged in this exercise of trying to send doctors because  doctors will not go there and in the mean time we lose the time/resources that could have been used to prepare and send appropriate health workers to VDCs. 

They have spent a few sentences on mental health which is very appreciable. 

Then, they talk about the proverbial "health tourism" and "private sector." I have discussed about it before. And my message is the same: if we are able to build something that is so good, you parties (the parties that claim to be fighting for the rights of the poorest, destitute and most vulnerable amongst us) should be bringing policies that would try to channel this good to the most needy amongst us: not to the medical tourists or "Bangkok Biramis."

In summary, UCPN-Maoists have thrown in a lot of pseudo-technicalities in their health care section. On deeper analysis, however, they are largely naive and populist. Their commitment to ensuring access to the majority of the citizens is appreciable.