As we have demonstrated in the last 9 posts, India has some serious challenges ahead of it. And despite the severity of the challenges like education, health care, and even sanitation, it has even bigger challenges still. The first of these, that we will address in this post, is the social norms.
The first challenge is with the general populace. For example, as Dreze & Sen chronicled in An Uncertain Glory, if asked, due to the fact that there is a model (if not an effective one) for bringing public health care to the rural areas and a growing private industry where you can presumably get what you need when you need it (if you can pay for it), most Indians believe they have reasonable access to health care. Given the considerable number of deaths from infection, the very high citizen to physician ratio, and the average number of people each health care center needs to serve, this is not the case. Secondly, due to the lack of progress on education, and the fact that 10 years after the first PROBE study there is still a significant lack of teaching days, there is obviously an opinion that the education being received by the average Indian child is adequate, which is a perception that is far from reality. There should not only be an uproar about the lack of teachers in some districts (as one per school clearly is not enough given the size of India’s population), but also an uproar that these highly paid individuals are absent 20%+ of the time!
The second challenge is with the government. The government doesn’t want to tackle tough issues, and certainly doesn’t want to take any steps that might cause a considerable backlash from any group of a significant size. Plus, if you look at the relative spending on health care and education in India versus other BRIC countries (Source: World Bank), total spending in India on health care (including the private sector) is a mere 3.9% versus 5.2% in China and 8.9% in Brazil, largely due to the fact that the public sector spend on health care is 1.2% of GDP compared to China’s 2.7% of GDP. If you look at Education, India spends a mere 3.1% (Source: Wikipedia) compared to China’s 3.9% (Source: Xinhuanet) and Brazil’s 5.1%. India is not adequately spending to address it’s most fundamental problems.
Government spending in India for 2013 is estimated at 302 Billion USD while revenues are projected to be 210 Billion USD. While that’s not a lot considering that India has over 1.2 Billion people, it’s still enough to do something. So where is the Indian Government spending its money? If you look at the Budget at a Glance as posted on the Government of India Site, over 1/3rd (37%) of the non-capital non-plan expenditures, which constitute almost 60% of projected expenditures, are going to interest payments and prepayment premium (370,684 crore of 992,908). The next biggest category (at 23%) is subsidies (231,084 crore of 992,908). The third biggest category (at 12%) is defence services (116,931 crore of 992,908). Grants make up 8%, pensions 7%, and the police make up 4%. The budget is rounded out by economic services at 2.4%, general services at 2.3%, and social services at a whopping 2.3%. (Taking us to 98.5% of the budget.) The remaining categories consisting of the postal deficit, the NDRF (National Disaster Relief Fund), union territory expenditures, and foreign government grants collectively amount to about 1.5%. Of the plan expenditures, all of the non-capital expenditures (27%) go towards the central plan and central assistance. In other-words, relatively speaking, India is spending too much on servicing its debt, paying its pensions, and defending its country and not nearly enough on education, health-care, and other economic assistance to lift the majority of its population out of near-poverty — a population it needs educated and healthy to take on China.
The third is with the media. As per Dreze & Sen’s An Uncertain Glory, among more than five thousand articles published on the editorial pages of India’s leading English-medium dailies during the last six months of 2012, less than 1% of the total editorial space was dedicated to health-related matters, and that was with a very broad definition of “health-related matter”. As we will discuss in more detail in a future post, the media really needs to spend more time on critical issues like health care, sanitation, and education.