By - King Stubb & Kasiva on January 18, 2024
Within the domain of fundamental human rights, the right to health assumes a prominent position. It is a universally recognized principle in international law via instruments such as the World Health Organization’s Constitution[1] and the Universal Declaration of Human Rights.[2] This right, which seeks to advance the utmost level of physical and mental health, demonstrates the international dedication to providing accessible and affordable medical care for every individual.
Rajasthan, in an unparalleled action, assumed a leading role by introducing the Rajasthan Right to Health Care Act, 2023, thereby becoming the first state in India to codify the right to healthcare through legislation.[3] Although widely regarded as a substantial advancement in improving the accessibility of healthcare for state residents, the Act encountered strong opposition from the medical community, specifically regarding reimbursement concerns. The Act, which is an admirable advancement in health care legislation in India, faces a nuanced landscape.
This article aims to analyze the situation leading up to the introduction of the Act, what it contains, and the loopholes associated in the following manner:
The Rajasthan Right to Health Care Act of 2023, was enacted in response to the critical need to address healthcare challenges in Rajasthan, India’s most populous state, home to more than 80 million people. Faced with adverse health and economic indicators, the state observed the need to enhance healthcare standards and alleviate families’ financial burdens. Despite already existing schemes like the Mukhya Mantri Nishulk Dawa Yojana[4], providing free medicines and medical equipment, the Chiranjeevi Insurance Scheme[5], offering a comprehensive medical insurance cover of ₹25 lakhs to all state families, alongside the Mukhya Mantri Nirogi Rajasthan Scheme[6] and Mukhya Mantri Nishulk Janch Yojna[7], individuals were responsible for roughly 60% of healthcare costs. This resulted in higher poverty rates and a reluctance to seek medical care.
The legislative process, initiated in 2018, faced various challenges, including opposition to an initially deemed radical draft and disruptions caused by the global COVID-19 outbreak. Finally, after extensive debate, referral to a select committee, and discussions, the Rajasthan Right to Health Care Act was passed on March 21, 2023. This act marks the beginning of a paradigm shift in the field of healthcare rights, which will be overseen by district and state health authorities.
Although the act is a much-welcome step, it suffers from several loopholes that need to be addressed for proper implementation per the legislative intent. Some of these challenges are as follows:
While the Rajasthan Right to Health Care Act, 2023 portrays remarkable progress toward healthcare accessibility, critical analysis of the legislation reveals significant loopholes. Complications arise from ambiguous emergency definitions, excessively delegated provisions, and a lack of conformity with existing laws. The Act’s success depends on how promptly those shortcomings are addressed. Moving forward, a nuanced strategy including the participation of all stakeholders, legal reform, and adherence to constitutional obligations is required to properly achieve the legislative aims and develop equitable and comprehensive healthcare in Rajasthan, thus paving the way for other states to follow.
The Act ensures the right to free emergency treatment without prepayment, covering medical care, critical care, and obstetric care.
In cases where patients cannot pay, healthcare establishments are reimbursed by the state government, as stipulated in the Act.
The Act requires district health authorities to decide on grievances within 30 days, and healthcare institutions must resolve complaints in three days; failure to do so leads to forwarding the complaints to the district health authority.
The Act mandates healthcare establishments to provide access to patient records, investigation reports, detailed bills, and information on healthcare providers, rates, charges, and the freedom to choose medicines or tests.
The Act proposes two state health authorities, one for logistical grievances and the other for treatment protocols, aiming to strengthen health-building policies and ensure efficient adjudication of grievances.
[1] https://www.who.int/about/accountability/governance/constitution.
[2] https://www.un.org/en/about-us/universal-declaration-of-human-rights.
[3] https://prsindia.org/files/bills_acts/acts_states/rajasthan/2023/Act7of2023Rajasthan.pdf.
[4] https://schemes.rajasthan.gov.in/scheme/detail/411.
[5] https://chiranjeevi.rajasthan.gov.in/#/home.
[6] https://schemes.rajasthan.gov.in/scheme/detail/972.
[7]http://rmsc.health.rajasthan.gov.in/content/raj/medical/rajasthan-medical-services-corporation-ltd-/en/services/MNJY0.html.
[8] https://cbhidghs.mohfw.gov.in/WriteReadData/l892s/The%20Clinical%20Establishment%20Act%202010-2013.pdf.
[9] https://main.mohfw.gov.in/sites/default/files/56987532145632566578.pdf.
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