ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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State and Health Markets in the Time of Pandemic

Counter-hegemonic Movement in India?

This paper attempts to explain three broad trends that underpinned the relationship between the state, market, and healthcare: first, the state is moving away from its health provider role to a regulator role, which involves shifting the resources, authority, and responsibility to diverse public and private actors. Second, in the name of the pandemic, the state has opened up fresh frontiers of privatisation and corporatisation of healthcare, extending to non-metropolitan cities and small towns. Third, the above two processes would lead to further exclusion of lower castes, classes, and genders from access to healthcare, spiralling health inequalities.

The author would like to thank Amar Jesani, Padma Prakash, and the anonymous reviewer for their insightful comments that helped revise the paper.

Across the world, governments, including the Indian state, presented the COVID-19 situation as an unexpected crisis to be dealt with as an emergency. And yet, as Rob Wallace (2016) argues, these pandemics are neither unp­recedented nor unexpected given the deeper connection bet­ween the capitalist agribusiness and aetiology of epidemics, ranging from SARS to Ebola to COVID-19 (emphasis mine). ­COVID-19, in fact, brought to the fore the fault lines across the world—countries without strong public health systems and with unequal access to resources, social inequality, democr­atic polity, state institutions, etc. While influenza, tuberculosis, malaria, HIV/AIDS continue to kill millions of people every year, ­COVID-19 has exacerbated health inequalities and insecure futures in India.

The government imposed lockdowns, containment, segregation, quarantine, etc, during the first wave of COVID-19 to control the spread of the virus. However, millions of migrants and informal workers, with no secure homeland of their own either in urban or rural India, went through widespread social suffering1 and died, not due to the virus but the failure of the state in providing basic entitlements. Engels (1891) called this social murder. He had argued that the then English ruling class and the state had created such horrendous working and living conditions for the workers, without the “necessities of life,” that they suffered not only ill health but met early deaths too. The suffering during the second wave was termed as the worst ­humanitarian and public health crisis in post-independence ­India (Bhatt et al 2021).

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Updated On : 5th Jun, 2022
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