You know that the rich and the middle classes are in danger when urgent appeals start to flood Twitter.
Here, with Covid-19, is a disease from which India’s upwardly mobile middle-and upper middle classes, and the rich, are not secure. In fact, they are the source and the biggest sufferers from it—after all, it was ‘foreign travel’ that brought the virus to the country’s shores.
As India hits nearly 350,000 cases of infections a day, it is—or at least ought to be—a turning point in the debate on healthcare in the country. A few things are certain: the stubborn belief that private companies would bear a large part of the healthcare burden is a mirage, even the relatively well-off are crushed by the expenses of the healthcare, and the country is not producing the volumes of trained healthcare professionals or infrastructure that makes it ready to face the challenges to come.
This is an inflection point because it—more than perhaps anything else in the last two decades—has taught the rich and the upwardly mobile that they cannot escape into a bubble bought by their relative prosperity while the poor suffer indignities caused by a fundamental lack of infrastructure and resources. It is that old bad habit in India of keeping one’s own home perfectly clean and dumping the garbage right outside. The moment it is outside, it is someone else’s problem. Who cares about the poor who have to deal with its consequences as long as the well-off can escape back indoors?
Over the years, as infrastructural and civic needs failed to keep up with the demands of a growing and more prosperous population, instead of campaigning for better civic services for all, India’s elite, and its growing middle class, found an easier path—buy private services to create bubbles for their comfort with little care about what happens to the rest of the country, and less privileged folk.
This is why, in spite of the fact that major Indian urban hotspots drown in torrential rains every monsoon, there is no public outcry. The people who could lead such protests have ensconced themselves in private gated communities, with private security guards, and personal domestic helps, and home delivery at their beck and call.
From Gurugram to Mumbai, Kolkata to Noida, the same story is repeated. No matter what the crisis, whether it is a major electricity problem, or terrible roads, or record-breaking air pollution, the rich and getting-richer have only one solution—throw money at the issue. Air pollution? Buy air filters at home and offices—but never bother organising mass petitions so that air pollution becomes a political, electoral issue. Unsafe cities? Private security guards. Bad healthcare? Private doctors, nursing homes, and, for the wealthier, a quick flight abroad for treatment. Poor schooling? Choose private schools at the highest price possible rather than fix public education. Why worry about transportation if you never need to use public transport? Who cares about how broken medical and nursing education are, until you realise, like right now, that no amount of money can buy you the attention of the best doctors who are stretched well beyond their limits?
For a long time, it was the habit of even top politicians in the country to slip out to western shores for treatment. It was never clear why they did not, instead, fix healthcare at home and take it to a standard where one would not have to go abroad.
India’s ‘free markets’ mavens—many of them with the unnecessary enthusiasm of the neo-convert—would forcefully advocate the privatisation of everything (because they knew, most of them, at least, had the money to buy whatever they needed). Now make no mistake, I am all for the free markets. Excessive government control has proved ruinous for the Indian economy for large parts of its history.
But it was never properly understood in India that the competition upon which the free markets operate must be built on the fundamental trust—the social contract, if you will—where the basics, like health and education, are available to every person.
Covid-19 is a turning point because even the most expensive and exclusive hospitals are running out of something as basic as oxygen. You can no longer buy yourself out of this crisis. And there is nowhere to fly off to because most countries have bars on visitors from places with a major surge in virus outbreak.
Those who would flip out a credit card to solve all problems are therefore reduced to tweeting desperately. It is a moment that could lead to deeper realisation about the inequities about our society, about the fact that we cannot grow in the manner that we want without addressing the foundational weakness, the core issues, as it were.
As my friend, the academic Abhinav Prakash tweeted, health insurance cannot help in a health crisis if there is no infrastructure. So, for all the people who used to advise that mass health insurance will resolve India’s healthcare needs, well, today they face the reality of the situation where insurance or no insurance, there are few beds to be had in hospitals, fewer oxygen cylinders still. No matter how lavishly funded your health insurance, without the infrastructure and systems, it is meaningless.
India—and most importantly, India’s rich and up-and-coming middle class—needs to realise that public services are the backbone upon which a unified society stands. You may throw the garbage outside, but its stink will slip in through your closed doors and windows and choke you too.
Great change comes from such inflection points, and if the Indian wealthy and relatively rich realise that their future is tied to better public systems, then this could well be our moment of salvation.
Views are personal. The author is a historian and a columnist. He is a multiple award-winning author of nine books.