People prefer to go for private education, healthcare

The latest round of survey, conducted by the National Sample Survey Organisation (NSSO) during the first half of 2014, has come out with data that offer significant insights into the current state of affairs in the country in important socio-economic sectors like education and health. There is an overwhelming trend of people going in for private delivery of services in these two sectors, as opposed to those delivered in the public sector. In education this is happening across rural and urban sectors, though the trend is more pronounced in urban areas. It is the same case in healthcare, with as many as 70 per cent of Indians going in for private healthcare services. In the process they are paying over four times more per hospitalisation for private care. Most of this money comes out of pockets as only 12-13 per cent of the population is covered by the public health insurance plan, Rashtriya Swasthya Bima Yojana. It is obvious what this is doing to the fight against poverty and the effort to raise Indian achievements in terms of human development indicators.

A health emergency for those seeking to get out of poverty often results in falling back into it. High regular private education expenditure for such people implies there is less money left for food, compared to what would have been the case had the quality of public education been acceptable. As India has about the highest number of children suffering from malnutrition in the world, it is imperative for the government to not just increase public spending in these social sectors but, perhaps even more importantly, improve the quality of delivery. As the National Democratic Alliance government is increasingly passing on resources as also social sector responsibilities to the states, public discourse in India must focus on how state administrative machineries can be made to sharply improve delivery. If the quality of delivery is the best in Tamil Nadu, then there needs to be an effort across the board to examine why what the southern state can do, others cannot. This must go hand in hand with efforts to better regulate private delivery.

Useful as the NSSO data are, it is also necessary to pose a question about its reliability. This particular round puts the overall national literacy level in 2014 at 69 per cent, whereas the Census of 2011 gives a figure of 74 per cent! There is also a difference in the rate of progress captured. According to the NSSO survey, in six years the country gained 4.6 percentage points in terms of literacy. But going by the Census figures, in the ten years between two Censuses (2001-11) there was a ten percentage point gain in literacy. This is not all. NSSO data put Andhra Pradesh at the bottom of the literacy league among states, whereas in the Census figures Andhra Pradesh ranks fifth from the bottom, with the last place going to Bihar. NSSO works through samples, whereas the decennial Census undertakes universal coverage. This does not mean sampling results will inevitably be inferior to what universal counts yield. What is important is to ask how efficient the two processes are, and to determine who needs to improve where.