- 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:
- lack of devices,
- shared devices,
- 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.
- 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.
- 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.