by Dr. Reeja Tharu on  April 14, 2009 at 7:26 PM India Special   - G J E 4
The National Health Bill, 2009, seeks to provide health, health equity and justice for all Indians. Medindia has attempted to highlight the fundamental features of the Health Bill and invites its readers to send in their feedbacks.

Right to Health

Every human being has the right to live in dignity and this can only be realized with good health and a sense of well-being. Health is a basic right of every human being - the real wealth which cannot be dispensed with. The right to health facilitates a person to fully enjoy the benefits of other basic human rights.

'Right to health' may be translated into timely and appropriate health care - the determining factors of which may be socio-economic, cultural and environmental.

The Constitution of India makes it mandatory for the Government to ensure fulfillment of the right to health for all without any discrimination under Articles 14, 15 and 21 (rights to life, equality and nondiscrimination).

The Supreme Court of India has on several occasions exhorted the Government to bestow health right with legal recognition and to treat it as a vital subset of the fundamental right to life. The National Human Rights Commission has also demanded that a health law must be enacted by the Government of India .

Sadly, in our country, the right to good standards of health is often denied and violated primarily due to the socio-economic imbalance. This is a cause of concern for all right -thinking individuals.

The recently -drafted National Health Bill (2009) by the Health Ministry encompasses all the tenets of health and health care including the underlying determinants and hopes to stride towards the mammoth goal of "health for all".

Important Features of the National Health Bill

  • Right to Healthcare - The recently drafted health bill 2009 seeks to legalize the 'right to healthcare', along with other issues associated with health rights

  • Good treatment - It will strive to ensure that good treatment be made available to the vastly neglected groups such as those affected by HIV/AIDS.

  • Collaborations between the Center and the State - The bill demands a broad legal framework (that involves cooperation/ collaborations between the Center and the State) for providing essential public health services and to monitor its functions, such as responding to public health emergencies.

  • Emergency Care - According to the National Health Bill 2009 'Patient's Right' includes emergency care. No individual should be denied emergency treatment because of his inability to pay fees or due to the requirement for police clearance

  • Patient Complaints - The new bill also seeks to make it mandatory for the hospitals to address patient complaints, on a 24 x 7 basis.

  • Name of doctor involved in treatment- Every patient has the right to know name of doctor / nurse involved in his treatment.

  • Summary & Second Opinion - Each patient has the right to avail of a summary of their condition and also to seek a second opinion.

  • Cost of Treatment- A patient may protest against overbilling, transferring elsewhere without valid reasons and for denying medical records

  • Rights of healthcare providers - The rights of healthcare providers is also likely to get legal recognition

The basic tenets of the Bill include -

  • People's rights relating to health and healthcare,

  • Obligations of governments and private actors,

  • Core principles / norms / standards on rights and obligations,

  • Institutional structure for implementation and monitoring

  • Judicial machinery for health rights.

However, the bill does not interfere with the regulatory tasks and administrative decisions to be taken by governments and local bodies, on the specific measures to be adopted to achieve the target.

The bill also empowers the government to review the existing laws and systems and to make new subordinate legislations and regulations and, overall, ensure the right to health of all people.

"It is hoped that this law would act as a critical tool to empower people about their health and to establish the responsibilities of government and private actors to deliver health rights in a just manner. While understanding the complex socio-economic and political underpinnings of health, it would hopefully serve as an additional device to catalyze the change," health ministry sources said.

Brains Behind the Bill

The recent bill is in response to the long- standing demand by public interest forums like Jan Swasthya Abhiyan. This organization, which is the Indian chapter of the International People's Health Movement, in liaison with the National Human Rights Commission (NHRC) had held public hearings on the health right issue in 2004 - a move has indeed paved the way for this bill.

The bill was drafted last year with the help of a task force comprising of lawyers, medical professionals and public health experts. During October 2008, the draft was presented to the health secretaries after which, in January this year, it was given to the State health ministers for their perusal and feedbacks.

The Tamil Nadu Chapter

It seems that HIV/AIDS is not such a big thing and that polio never ever existed, thanks to the Tamil Nadu Public Health Act which does not even render a passing mention of these two dreaded diseases. The reason for this folly is due to the fact that the Act was framed as early as 1939 (then known as the Death Relief Act) when these diseases were little known. Strangely, this Act guides the public health policy in the state even today.

Minor amendments were made in 1990, nevertheless significant changes need to be made to cater to the requirements of a fast- changing society and its faster -evolving pathogens.

For the very first time the State government has proposed a complete modification of the Tamil Nadu Public Health Act to suit public health requirements and to create a new legal framework that would enable a better response to public health emergencies.

Justifying the need for such sweeping changes, the TN Public Health Act Amendments Committee has noted: "Population dynamics, migration, changes in climate, lifestyle changes and the developments in the transport system are the major causes of epidemics and pandemic threats."

In the amendment infectious diseases such as HIV/AIDS, hepatitis, chikungunya, malaria, polio and dengue have found mention for the first time ever.

"Some of these infections were not even heard of when the Act was first framed, but as we move ahead, we have to take the law with us," says Dr. S. Elango member secretary of the Committee

In the interest of public health, the amendment seeks to regulate the use of plastic, its abuse and its disposal. Plastic is to be categorized as offensive matter as it can cause health hazards.

Public disposal of wastes has been updated to include biomedical wastes and toxic chemicals/substances.

According to Dr. Elango, changes are also sought in government administrative machinery and there is to be an increase in the fine amount for any violation of the Public Health Act.

Many of the Central Govt. health Acts are obselete and have no meaning. Most were written with the Government hospitals in mind without looking at the private sector hospitals. Today majority of healthcare in the country is being delivered by these private hospitals. One of the first few acts that need to be amended include the Mental Health Act.

Waiting For Their Turn

The Union of India is yet to legislate on the following-

  • Population stabilization and family planning

  • Registration of births and deaths and other vital statistics for health

  • Mental health;

  • Drugs and food safety;

  • Fertility treatment

  • Labor safety and welfare, includingmaternity benefits;

  • Education, employment, Social security and social insurance;

  • Legal / medical professions;

  • Prevention / control of communicable diseases;

  • Port quarantine, seamen 's and marine hospitals

The Union of India has also signed various international agreements, declarations and treaties, related to the implementation of the right to health. As the Indian Healthcare system is almost crumbling, it is necessary to activate these treaties effectively and to pass the National Health Bill at the earliest.

Source: Medindia
Dr Reeja Tharu

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After reading through the Health Care Bill of 2009. I don not feel it addresses the issue of cost. As a full time employee with a PPO option in the North West. I feel the bill should make sure Doctors, Medical Centers and the like does not pass on the cost of their Insurance write offs to patience like myself. I currently paying over $5,000.00 a year in co-pays and premiums. at a 7.5 % AGI can never claim these out of pocket expense on my 1040. I guess those of us that are able to afford health care will pay to cover the once that do not want to pay. We should not settle for a mediocre bill!
jhoannaj Sunday, August 30, 2009
Why do some small country have better health systems. then the riches country in the world??
weesp Saturday, August 15, 2009
Becoz some of the smaller countries spend more of their GDP on Health. The Govt of India only spend 0.9% whereas it should be spending at least 10% on GDP on health needs of the people .
sunny1 Sunday, August 16, 2009
Here is the problem the health care in place doesn,t pay DRS. the needed fees for them to practice and help patients. The medicaid/medicare is not providing the right to health care. It is a nightmare trying to find a surgeon who accepts medicaid/medicare. It is another impossible task trying to find a DR. who accepts whats in place. They MUST pay DRS. a higher fee. Barbara A.
Barba Saturday, August 15, 2009
sound good,but where can i read the proposed new heath care bill myself. thanks robert
robert1950 Tuesday, July 21, 2009
This is a hugely important bill for India and its public. I do hope people read and send their feedback to the Govt. so that all the elements are covered before the bill is enacted. The draft bill is available though it runs into almost 300 pages. Medindia's gist is helpful to get started. post a discussion on this topic that can be forwarded to the Govt.
prema Tuesday, April 14, 2009

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