HEALTH RELATED ISSUES

Directions (1-8): Read the following passage carefully and answer the respective questions given below each of them. Certain words/phrases/sentences have been printed in bold to help you locate them while answering some of the questions.

The “best health care at the lowest possible cost” should be: inclusive; make health-care providers accountable for cost and quality; achieve a reduction in disease burden, and eliminate catastrophic health expenditures for the consumer. All of this is not happening overnight simply because an audacious, nation-wide health-care programme is on the anvil. It could come about, however, if accompanied by the nuts and bolts of good governance that will support solutions and systems to achieve these objectives.

In the matter of inclusion, over 15 years ago, the Vajpayee government commissioned the Institute of Health Systems (IHS), Hyderabad to develop a ‘family welfare linked health insurance policy’. In 2003, the Director of the IHS Hyderabad delivered a broad-based Family Health Protection Plan (FHPP), open to all individuals. (A) The fact is that any discourse on universal health care in India gets stymied by the sheer size and ambivalence of the numbers involved. This 2003 solution of the Vajpayee-era recommended, inter alia, that good governance lies in aligning the income lines for health and housing. In other words, de-link entitlement to health care from the poverty line. In that event, the income lines for housing (updated from time to time), could be simultaneously applicable for health entitlement. The government could then proceed, as per capacity, to scale the health premium subsidy in line with housing categories — economically weaker sections (entitled to 75-90%), lower income (entitled to 50%), and middle income groups (entitled to 20%).

The NHPM is pushing for hospitalisation at secondary- and tertiary-level private hospitals, while disregarding the need for eligible households to first access primary care, prior to becoming ‘a case for acute care’. (B) We are in danger of placing the cart before the horse. Without the stepping stone of primary health care, direct hospitalisation is a high-cost solution.

Public sector health capacities are constrained at all levels. Forward movement is feasible only through partnerships and coalitions with private sector providers. These partnerships are credible only if made accountable. The National Health Policy 2017 proposed “strategic purchasing” of services from secondary and tertiary hospitals for a fee. Clearly, we need to contract-in services of those health-care providers (public and private) who are assessed as competent to provide all care for all the medical conditions specified; who will accept and abide by standard treatment protocols and guidelines notified, as this will rule out potential for induced care/unnecessary treatment; and who will accept the AB-NHPM financial compensation package (with fixed fees per episode, and not per visit).

The credo for participating private providers should be “mission, not margin”. Health-care providers (public/private) should be accredited without any upper limit on the number of service providers in a given district. The annual premium for each beneficiary would be paid to those service providers, for up to one year only (renewable), as selected by beneficiaries. The resultant competition would enhance quality and keep costs in check. Upgrading district hospitals to government medical colleges and teaching hospitals will enhance capacities at the district level. Service providers will become accountable for cost and quality if they are bound to the nuts and bolts of good governance outlined above.

Q1. In the passage above, a line is given in Bold as (B)We are in danger of placing the cart before the horse. What does the author mean by this statement?

1. We are not dealing with the situation with proper arrangements and planning.
2. We are placing higher-level care before the primary care.
3. We are disregarding mental health in front of physical health.
4. Both (b) and (c)
5. None of the Above

Solution:

In paragraph 3, it can be inferred that we are disregarding the first access to primary care and pushing for hospitalisation at secondary and tertiary level. Hence, the meaning of the statement here is 'We are placing higher-level care before the primary care'.

Q2. What is the meaning of the phrase 'Nuts and Bolts' used in the passage above?

1. The plethora of Activities
2. The persons responsible for a particular job
3. The basic practical details
4. The necessary requirements for a healthy life
5. None of the Above

Solution:

The phrase 'Nuts and Bolts' means the basic practical details (of something).

Q3. There is line given in BOLD in the above passage, (A) The fact is that any discourse on universal health care in India gets stymied by the sheer size and ambivalence of the numbers involved. Which of the following most nearly describes the same meaning as the original sentence and contextually fits in correctly?

1. The fact is that any debate on universal health care in India gets highlighted by the small size and abundance of numbers involved.
2. This is a fact that any discussion on universal health care in India is hindered by the complete size and fluctuation of numbers involved.
3. This is a fact that any discussion on universal health care in India is disregarded by the complete size and excess of numbers involved.
4. This is a fact that any decision on universal health care in India is surged by the complete size and fixed numbers involved.
5. None of the Above

Solution:

The statement that nearly means the same here is 'This is a fact that any discussion on universal health care in India is hindered by the complete size and fluctuation of numbers involved.'

Q4. Which of the following could be the most appropriate title for the above passage?

1. Ayushman Bharat unfolds
2. The primary anchor of a health-care road map
3. Long Road Ahead | Managing Health Institutes
4. Discouraging Health Expenditures
5. None of the Above

Solution:

The most appropriate title for the passage is "The primary anchor of a health-care road map". As the passage deals with implementation of National health scheme and what are the primary requirements before implementing any such scheme and what should be the focus areas. Anchor means a person or thing which provides stability or confidence in an otherwise uncertain situation. Hence, the title becomes relevant.

Q5. Which of the following statements is/are correct in the context of the above passage?

(I) Best health care at lowest possible cost should be able to eliminate catastrophic health expenditures for the consumer.

(II) Private health benefits providers should aim more on the mission rather than their profit margin.

(III) Private hospitals who will shoulder the bulk of the in-patient scheme already face a trust deficit because of instances of fleecing.

1. Only (I)
2. Only (II)
3. Both (I) and (II)
4. Both (II) and (III)
5. All of the Above

Solution:

Both statements (I) and (II) are correct here.

Statement (I): Refer passage 1, first two lines.

Statement (II): Refer last paragraph, 1st line.

Q6. Which of the following is most SIMILAR to the word given in bold in the above passage?

AUDACIOUS

1. Ashamed
2. Unobtrusive
3. Brassy
4. Timid
5. Heedful

Solution:

Audacious: showing a willingness to take surprisingly bold risks.

Brassy: displaying or marked by rude boldness

Q7. Which of the following is most OPPOSITE in meaning to the word given in bold in the above passage?

FEASIBLE

1. Attainable
2. Plausible
3. Snap
4. Nonviable
5. Cinch

Solution:

Feasible: likely; probable.

Nonviable: not feasible or practical.

Q8. Which of the following statements is/are incorrect in the context of the above passage?

(I) In 2003, the Director of the IHS Hyderabad delivered a broad-based Family Health Protection Plan (FHPP), open to all individuals.

(II) Upgrading district hospitals to government medical colleges and teaching hospitals will enhance capacities at the district level.

(III) The government has committed for two-thirds of resources to go into a comprehensive primary health care as part of the National Health Policy 2017.

1. Only (I)
2. Only (II)
3. Only (III)
4. Both (II) and (III)
5. All of the Above

Solution:

Only statement III is correct here. Nothing has been given about the quantity of resources to go into primary health care. Statement I can be inferred from paragraph 2 and statement II can be inferred from the last paragraph of the passage.

Directions (9-15): Read the following passage carefully and answer the respective questions given below each of them. Certain words/phrases/sentences have been printed in bold to help you locate them while answering some of the questions.

Passage-2

Amidst several parameters going askew for the Indian economy, two ~ its current account deficit and its sliding rupee ~ are attracting the greatest outcry, more so because of the shrill assault that the present Prime Minister had launched against his predecessor during the 2013 slide of the rupee. At 72.23 to the dollar, the Indian rupee is among Asia’s worst-performing currencies with nothing on the horizon auguring well for it, particularly with there being no reason to expect a decline in oil prices.

The 2014 oil price decline had helped stabilize the rupee after the 2013 debacle. With oil imports a given, not all the cheer about improved exports spurred by a weaker rupee can do much to change India’s sharply widening trade deficit, at $17.39 billion in August 2018 (up from $12.72 billion in the corresponding month a year earlier), thanks to imports surging 25.4 per cent to $45.24 billion. India’s current account deficit (CAD) widened to $15.8 billion (2.4 per cent of the gross domestic product GDP) in the second quarter of 2018 from $14.9 billion a year earlier (2.5 per cent of the GDP).

What has been sustaining the CAD thus far are global flows, a basket of foreign direct investment and portfolio investment supported by foreign reserve management. Indeed, FDIs have been supportive of the Indian currency in the past, when global financial conditions were not as tight. Currently, portfolio investments are under pressure and the first quarter of 2018 has seen a net outflow of $8.1 billion on this account from a happy inflow of $2.3 billion inflow in the last quarter of 2017.

Given the current circumstances ~ including the uncertain political scenario ~ and past trends, the International Monetary Fund assesses that global markets may not be able to finance a CAD above three per cent of GDP and even optimistic projections place the CAD at 2.9 per cent of the GDP. In essence, India may well have kick-started a vicious cycle with a higher CAD putting the rupee under greater pressure, increasing costs of overseas borrowing, further affecting India’s foreign exchange reserves, which have been falling over the past few months.

India’s forex reserves fell to $ 399.282 billion on 7 September 2018 from $ 400.100 billion. This slippage to under $ 400 billion happened for the first time in a year and indicated that the Reserve Bank of India was selling dollars to stem the fall of the rupee. A drop in foreign currency assets (FCAs) was mainly responsible for the country’s plight.

It goes without saying that falling forex reserves would send the CAD further north and force the government into uncomfortable straitjackets. It has been forced to contemplate five measures including curbs on non-essential imports. Industries dependent on some of these imports will be the first to start screaming.

Q9. Which of the following has/have been sustaining the Current Account Deficit in context of the passage above?

1. Foreign Direct Investment
2. Portfolio Investment
3. Curbs on non-essential imports
4. Both (a) and (b)
5. All of the Above

Solution:

Both Foreign Direct Investment and Portfolio Investment have been sustaining the current account deficit. Refer 3rd Para first two lines.

Q10. Which of the following is/are true in context of the passage above?

1. India’s forex reserves fell to $ 399.282 billion from $ 400.100 billion.
2. India’s current account deficit (CAD) widened to $14.9 billion in the second quarter of 2018
3. The first quarter of 2018 has seen a net outflow of $8.1 billion
4. Both (a) and (c)
5. None of the Above

Solution:

Both (a) and (c) are correct here.

Q11. After the 2013 failure of Rupee, what helped it stabilize in 2014?

1. Increase in FDI
2. Wide Trade Deficit
3. Both (b) and (d)
4. Decline in Oil Prices
5. None of the Above

Solution:

Refer the following line in paragraph 2, 'The 2014 oil price decline had helped stabilize the rupee after the 2013 debacle'.

Q12. Which of the following could be the most appropriate title for the above passage?

1. Past Trends of Economy
2. Declining Imports and Exports
3. Rupee at risk
4. The Uncertain Political Scenario
5. None of the Above

Solution:

The most appropriate title for the passage is 'Rupee at risk' as it deals with various factors affecting decline of rupee and which put its value at risk.

Q13. Which of the following is most SIMILAR to the word given in bold in the above passage?

DEBACLE

1. Corker
2. Smash
3. Dandy
4. Catastrophe
5. Both (b) and (d)

Solution:

Debacle: a sudden and ignominious failure; a fiasco.

Synonym: Catastrophe

Q14. Which of the following is most OPPOSITE in meaning to the word given in bold in the above passage?

CONTEMPLATE

1. Muse
2. Deliberate
3. Opine
4. Disregard
5. Both (a) and (d)

Solution:

Contemplate: think deeply and at length.

Antonym: Disregard

Q15. What style of writing has been used in the passage above?

1. Expository
2. Descriptive
3. Persuasive
4. Narrative
5. None of the Above

The style of writing used in the passage is Expository. The passage consists of various facts and figures, thus making it expository