The Weekly Dose: CAAn someone call a doctor?
What effect will granting - and more importantly, stripping someone of the right to live in our country have on their access to healthcare? Can subsidised treatment be denied to someone bereft of the trump card of citizenship? If the Citizenship Amendment Act is enforced, and a National Registry of Citizens drawn up, who will take responsibility for the health of millions who may be imprisoned or deported?
In this winter of our discontent, the alphabet soup of CAA-NPR-NRC has not warmed the cockles of our hearts. Its bewildering broth of policies and law proved difficult to swallow, but was forced down our throats, and has left us with a bitter taste disputed by bitter tongues.
Pens more erudite than mine have written reams of columns about how this trifecta of unabashedly biased acts will alter the very meaning of what it means to be an Indian. Having read and contemplated their opinions, I began to wonder: what effect will granting - and more importantly, stripping someone of the right to live in our country have on their access to healthcare? Can subsidised treatment be denied to someone bereft of the trump card of citizenship? If the Citizenship Amendment Act is enforced, and a National Registry of Citizens drawn up, who will take responsibility for the health of millions who may be imprisoned or deported?
I don’t have answers. Neither, apparently, does anyone in this government, whose response to the myriad raging questions thrown up by its obdurate act of discrimination has been to clarify nothing. So, I consulted the Gita, Quran, Bible, Avesta, Agama and Guru Granth Sahib of democracy, which this regime regards as a set of suggested, optional guidelines compiled by idealistic fools: the Constitution of India.
New Indians, new entitlements
The CAA bequeaths citizenship upon hitherto illegal migrants from three Muslim-majority countries, provided they profess any religion but Islam. This means that a Christian from Karachi, a Zoroastrian from Pakistan and a Hindu from Bangladesh - all minorities in their respective countries - have the right to Indian citizenship, while a Hindu from Sri Lanka or a Muslim from Myanmar - also minorities - do not. None of the above individuals has any claim to being Indian, yet some can now assert this right, while others no longer have the right to stay in this country and enjoy its privileges.
In the South Asian region, India is a magnet for patients from neighbouring nations seeking affordable, specialised healthcare; I remember a man who brought his HIV-positive child from Nepal to Mumbai every fortnight for treatment. If implemented, the CAA will shut these doors to some, and expel those still in dire need of medical expertise.
The NRC exercise in Assam was a fiasco in which almost two million legitimate Indian citizens were left out. For the sake of argument, let us assume this figure corresponds to the real number of illegal Muslim migrants in the state, who - under the CAA - can be interned or deported. The same law allows non-Muslims from neighbouring Bangladesh to gain Indian citizenship after a much shorter waiting period; the government has allowed religious persecution, or fear of it, as a reason for them to become Indians.
One functionary said that no-one who came to stay in India after 2014 will be offered this gift, but it is universally known that the Indo-Bangladesh border is porous and that there are 17 million Hindus in that country. Indian citizens have the right to live and work anywhere in India; new immigrants will naturally gravitate to the state where their language is spoken. How is West Bengal - which shares a common language with Bangladesh - supposed to provide health facilities for such a potentially huge number of migrants?
Migrants typically live in border districts, close to their home countries. These areas are far from administrative centres and are already struggling with a paucity of health facilities and personnel. A sudden influx of residents will further stretch resources that hardly exist.
Who will pay?
That India spends a pitiful fraction of its GDP on public health is well known; lesser known is the fact that according to the Constitution, health is a State subject i.e the responsibility of individual states. The latter can fulfil this responsibility partly because of funds disbursed by the Centre; one of the factors that decides a state’s share of this kitty is its population. The Finance Commission arbitrates this division. Since the results of the National Population Register exercise - scheduled for later this year - won’t be available until at least next year, the Commission - whose report is due in a couple of months - will have to rely on the 2011 census to recommend how much money should devolve to states over the next five years, without accounting for the multitudes who may stream into India in that period, demanding healthcare.
The disenfranchised and the Right to Health
What happens to the life and health of Muslims - and only Muslims - who will be arrested and interned in camps, pending possible deportation? Fortunately, the Constitution grants all people living in India - not just citizens - the Fundamental Right to Life, which has been read by courts of law to include the right to health. However, Article 15 prohibits the State from discriminating on the basis of religion against citizens, not all people. It forbids the government from restricting citizens’ access to public facilities like hospitals maintained by government funds, not people’s access. Undocumented Bangladeshi workers have no right to public healthcare since Article 39 directs the government to secure the health and strength of working citizens only.
Providing information - including biometric details - for the NPR is mandatory for every person living in India. The biometrics will be verified from the Aadhaar database. Regarding any link between the NPR and NRC, the government’s idea of public relations is sending out smoke signals: Home Minister Amit Shah has said there will be no link, Law Minister Ravi Shankar Prasad says ‘some’ data from NPR will be used in NRC; in Assam, authorities have announced that those left out of the NRC will not be able to obtain an Aadhaar.
The Supreme Court has ruled that Aadhaar is ‘compulsory for those who seek to receive any subsidy, benefit or service under the welfare scheme of the government, expenditure whereof is to be met from the Consolidated Fund of India.’ In short, if you don’t make it to the NRC, no Aadhaar and no subsidised healthcare.
Not only does the CAA divvy out citizenship based on religion, but it also deprives the poorest of the poor Muslims - economic refugees from other countries - the right to live a healthy life, and consequently, the right to live.