Imphal Review of Arts and Politics

Healthcare must be made a fundamental human right

The Necessity Today is For a Non-reformist Transformation of Healthcare System in Manipur

Those people in Manipur who are at the bottom of social pyramid believe it was written in their fate when they lost their loved one due to their inability to afford health care for the latter. While it is crucial to question the state as to why poor people are unable to obtain health care, no one appears to have the guts to stand up and demand that health care be made accessible to all. Nor do they strive to figure out how the political and economic structure of the state prevents them from accessing the healthcare system? It is clear that many people in the state have died from COVID-19 because they cannot afford medical treatment. However, this is not a result of fate, but rather of an unscrupulous health-care system.

The Cuban healthcare system built on revolutionary socialist philosophy can help us comprehend this. In Cuba, health care is a human right, so it is a national priority. The system focuses primarily on preventative measures, providing free services ranging from routine checkups to major surgery. To Cuban physicians, being a doctor is motivated by a desire to help others, which I refer to as proletariat morality, rare in our country. The system is so perfect that it assures that an open heart surgery does not result in lifetime debt, as is common in our system.

We currently live in a society governed by a capitalist system, which I feel is self-evident.  It’s also apparent that nothing we’ve seen in the current economic and political system is socialist. The wealthy established factories to profit by exploiting or defrauding the poor within a capitalist system; human history bears witness to this. So in the present Indian economy, building a private hospital in the state is no different from establishing an automobile plant, as both have the same primary aim: making a profit.

If one were to debate with a capitalist on “why the poor have no access to healthcare,” the capitalist would argue that the poor are unable to do so because they cannot afford the medical treatment that capitalists give or rather sell in hospitals. However, neither capitalists nor bourgeois academics are honest enough to disclose society’s poverty-producing condition. Instead, they will refer to the poor as ignorant, unintelligent, and unproductive. That is how capitalists persuade people that healing disease requires individual rather than collective societal effort, which is incorrect and serves only to further their domination.

Their argument ignores the deep class structure and exploitative production relations that is the root of their plight. As a result, in a society like ours, where there is no true revolutionary vanguard to elevate people’s consciousness level, people have become trapped by capitalist doctrines and have begun to accept them. Over time, they have got oppression and the oppressive social condition in which they find themselves as their destiny.

By carefully analyzing the operations of private hospitals, the socioeconomic class and class exploitation that exists in society might be exposed. Private hospitals, which are popping up all over Manipur, aren’t there to help people but earn money. No one can view them as healthcare providers who value people and save lives from whatever angle. After observing how they treated the have-nots during the covid-19 pandemic, their motive for running a hospital becomes all the more explicit.

Let’s look at the salary of a lower echelon health care worker in a private hospital. Tombi, for instance, finished her ANM nursing program last year and began working at a private hospital in Manipur. Her basic initial pay is Rs. 5000 per month because she is new to the hospital. According to empirical statistics, many nurses work for private hospitals and get a monthly wage of Rs. 3000. It is also a socioeconomic truth that the majority of nurses in our state come from low-income families or families on the lower rung of the social ladder. The point is, almost every nurse working in private hospitals comes from the poor section of society.

They work long hours, like factory workers in the twentieth century, but are only paid Rs. 3000 per month, implying that their labor time is robbed and they are grossly underpaid.  If you divide their monthly income by 30, you’ll get a daily labor value of Rs. 100, which is far too low. To be honest, her one-day service to the hospital won’t allow her to receive one-day medical care at the same hospital. What medical treatment can she obtain from the private hospital for her Rs. 100?

How can a nurse’s daily labour be Rs. 100 when a “loukhaobi” earns Rs. 500 per day? So, it is evident that they have been exploited for more than 400 rupees each day. If they were exploited for Rs. 400 each day, the total amount of labor value exploited in a month would be Rs. 12,000, making the total amount of labor value exploited Rs. 144,000 per annum. Do you feel that if they are treated this manner, they will become economically stable in the future? So, no one can deny that hospital owners’ net worth comes from the healthcare workers’ exploited labour values. Isn’t that looting the workers?

Unfortunately, a patient getting medical care at the COVID ICU unit nowadays must pay more than Rs. 17,000 each day at private hospitals.  If the patient has to be treated in a general ward, the charge will be at least Rs. 6,000 per day. In this situation, if a relative of a nurse working in the same hospital has been tested positive for COVID-19 and is required to be admitted, how many days can that nurse afford health care for her mother/father/brother/sister with the money she received from the hospital as her salary? Will her whole one-month salary of Rs 3000 or Rs. 6000 be enough to cover five days of the patient’s medical care? Surely, she won’t be able to keep her relative in the hospital for more than a day? Does this imply that she cannot get medical treatment for her mother because she is not as hard-working as the oppressors, despite the fact that she works a full day in the hospital every day?

Don’t you still think there’s something wrong with the system as a whole? For the nurse, selling her labor power isn’t enough to save her parents; she now needs to sell her property as well, whether it’s their land or their house, to provide medical treatment for them, as is common in our society. If one examines this basic example closely, one can see how the healthcare system reflects society’s class structure and oppression.  It can also be argued that impoverished people will be denied access to healthcare facilities since the healthcare system was not designed with citizens’ access to it as a key purpose. Rather, it’s about squeezing maximum profit out of people. Profit takes precedence over humanity for them.

So weathering the COVID-19 pandemic, which is wreaking devastation across the state, will be beyond this healthcare system’s capabilities. Now is the time for a new healthcare paradigm, with the primary goal of ensuring that everyone has access to it rather than profiting from it. For this, we don’t need any form of change based on false benevolence, as we see in bourgeois philanthropists’ reform efforts. Rather, society requires a radical change involving non-reformist reforms based on concrete types of political struggles.

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