CONTEXT 

• The novel coronavirus pandemic has accelerated the use of digital technologies in India, even for essential services such as health and education.
• But the data shows that automated decision-making tools have exacerbated the inequalities, especially by raising the barrier for people to receive services they are entitled to.

INCREASED ECONOMIC INEQUALITY

• The people whose jobs and salaries are protected, face no economic fallout; Super-rich have even become richer.
• On the contrary, the bulk of the Indian population is suffering a huge economic setback.
• Several surveys conducted over the past 12 months observed the widespread job losses and income shocks among those who did not lose jobs.

THE SWITCH IN LEARNING

• Worse than the immediate economic setback is that well-recognised channels of economic and social mobility — education and health — are getting rearranged in ways that make access more inequitable in an already unequal society.
• For a few, the switch to online education has been seamless, while a significant number of the most vulnerable are struggling to access online education.
• Two such cases highlight the helplessness where young students took their own lives because they could not cope — a college student studying in Delhi and a 16-year-old in Goa whose family could not afford to repair the phone he used.

ACCORDING TO THE SURVEYS

• According to National Sample Survey data from 2017, only 6% rural households and 25% urban households have a computer.
• Access to Internet facilities is not universal either: 17% in rural areas and 42% in urban areas.

Surveys by the National Council of Educational Research and Training (NCERT), the Azim Premji Foundation, ASER and Oxfam suggest that between 27% and 60% could not access online classes for a range of reasons:

1. lack of devices,
2. shared devices,
3. inability to buy “data packs”, etc

• Further, lack of stable connectivity jeopardises their evaluations, for e.g. the Internet going off for two minutes during a timed exam.
• Besides this, many lack a learning environment at home. For instance, 25% Indians lived in single-room dwellings in 2017-19.
• For girls, there is the additional expectation that they will contribute to domestic chores if they are at home.
• Peer learning has also suffered, leaving children from section worst affected.

HEALTHCARE

• India spends abysmally low public spending on health i.e. barely 1% of GDP.
• As a result, the share of ‘out of pocket’ (OOP) health expenditure (of total health spending) in India was over 60% in 2018.
• On the contrary, even in a highly privatised health system such as the United States, OOP is merely 10%.
• Moreover, the private health sector in India is poorly regulated in practice.
• Thus, these factors put the poor at a disadvantage in accessing good health care.

FAULTY HEALTHCARE SOLUTIONS

• Amidst the pandemic situation, the focus is on the shortage of essentials: drugs, hospital beds, oxygen, vaccines.
• In several instances, developing an app is being seen as a solution for allocation of various health services.
• These solutions are based on assumptions that these will work because of people’s experience with platforms such as Zomato/Swiggy and Uber/Ola, leaving behind poors.
• Digital “solutions” create additional bureaucracy for all sick persons in search of these services without disciplining the culprits involved in hoarding and black marketing.
• Thus, along with paperwork, patients have to navigate digi-work, while excluding the poor entirely, or squeeze their access to scarce health services further.

For e.g. the use of CoWIN to book a slot makes it that much harder for those without phones, computers and the Internet.

• Also there are reports of techies hogging slots, because they know how to “work” the app.
• Besides all, the website is only available in English.

CONCERNS FOR PRIVACY

• The digital health ID project is being pushed during the pandemic when its merits cannot be adequately debated.
• The push comes with the purported benefits like electronic and interoperable health records.
• The Indian government is intent on creating a centralised database.
• But the concerns have been raised on the interoperability of such a project  which can be achieved by decentralising digital storage (say, on smart cards) as France and Taiwan have done.
• Also, at present India lacks a data privacy law, hence it is very likely that our health records will end up with private entities without our consent, even weaponised against us
• For e.g., private insurance companies may use it to deny poor people an insurance policy or charge a higher premium.

CONCLUSION

• Technological changes in education and health are worsening the existing inequities.

• The privileged are getting ahead not necessarily because they are smarter, but because of the privileges they enjoy as compared to the poor sections.
• Unless health expenditure on basic health services is increased, apps such as Aarogya Setu, Aadhaar and digital health IDs can improve little.
• Unless laws against medical malpractices are enforced strictly, digital solutions will distract us from the real problem. Thus, there is a need for political, not technocratic, solutions.
• Hopefully, the pandemic will teach us to be more judicious about which digital technologies we embrace.

Reference:

1. https://www.thehindu.com/opinion/lead/decoding-inequality-in-a-digital-world/article34529983.ece