Does the Right to health, and the right to get proper treatment in government and private hospitals, exist on the ground for the ordinary Indians who do not have a surfeit of money or influence? Given the orders issued by various courts and the National Human Rights Commission in recent months to various governments, the answer, sadly, lies in the negative.

Ordinary citizens of the country are not getting the healthcare which they are guaranteed under the constitution, as the right to get proper treatment stems from the Fundamental Right to Life enshrined in our constitution. The Right to Life has itself been held to be a Right to Life with Dignity and not a right to mere existence. A life of dignity includes the right to get treatment when one is not well.

Even as the poor are not getting the treatment that they have a right to, the question that arises is whether their situation is improving on this front? Without doubt, the initiatives taken by various states and the Central government are providing free treatment to the poor in government hospitals. The State has also mandated that the hospitals, which get subsidized land from the government, must treat a certain number of the below poverty line patients free of cost. This has certainly resulted in a lot of poor patients getting treated free of cost in such facilities. This can be called an improvement.

However, the lack of healthcare infrastructure in the country to provide treatment to the tens of crores of poor people remains a hurdle to the full realization of the Right to Health in the country. Lack of diagnostic facilities, lack of medicines, shortage of doctors and nurses, lack of basic infrastructure in healthcare facilities are all together creating a bottleneck on the supply side in the healthcare delivery which is stymying the Right to Health of the populace.

The implementation of the Ayushman Bharat Scheme with the stated objective of providing free healthcare for a very large number of health conditions to some fifty crore disadvantaged Indians is a move that has the potential to translate the Right to Health of the citizens on the ground in a substantial measure. However, the Ayushman Bharat Scheme faces the same bottlenecks which have hitherto thwarted our governmental healthcare delivery, including lack of infrastructure and manpower.

Can Ayushman Bharat overcome the bottlenecks and truly translate the Right to Health on the ground? Yes, it can. For that, the scheme will have to make it reasonably profitable for the already established hospitals in the private sector to treat the fifty crore identified Indians who have been guaranteed free healthcare. It is this profit motive that will attract fresh investments in private sector hospitals, which alone can cater to this huge volume of potential patients, and thus satisfy their Right to Health.

Without an overwhelming and dominant role by the private sector hospitals, it is not possible for India to translate the Right to Health of its citizens on the ground. The healthcare facilities in the government sector have been money-guzzlers, and the outcome delivered by them has been neither cost-effective nor substantial. If the money that goes every year into building and maintaining the healthcare facilities in the government sector is used for paying the private hospitals only for the actual treatment rendered by them, the money will go much farther and the Right to Health of the people will be met.

This indicates that there is a case for handing over on lease the existing healthcare facilities in the government sector to private entities with a condition that they must treat a certain number of patients every year free of cost under the Ayushman Bharat Scheme. This number of patients can be more than the number being treated in these facilities as of now. These offers can be given to groups of doctors, who come forward to run these facilities.

In this way, the existing infrastructure in the government healthcare sector would be put to maximum use, to the benefit of patients, with no additional load on the governmental budget. And, the Right to Health of the fifty crore Indians will be guaranteed in full measure.

The success of the Ayushman Bharat Scheme will be determined by the number of patients that it benefits. If the lack of profit keeps the private sector away and  bottlenecks continue in the government sector, the scheme will have to address these challenges to achieve success.