Content

1. India’s demographic dividend as a time bomb
2. Building health for 1.4 billion Indians

India’s demographic dividend as a time bomb

Basics / Background

• Rabindranath Tagore’s Quote: Children must not be restricted to past learning; they are born for the future.
• Present context:
  • India’s education system remains outdated, exam-centric, and degree-driven.
  • The future of work is being shaped by AI and emerging technologies.
• Demographic Dividend:
  • India has 800+ million people under 35.
  • This can be an asset or a liability depending on education–employability alignment.

Relevance : GS 1(Society ),GS 2(Social Issues)

Practice Question : India’s demographic dividend risks turning into a demographic disaster unless education and employability are aligned. Critically examine.(250 Words)

Why the Crisis Exists

• Curriculum lag: Update cycle in schools/colleges = 3 years, whereas job requirements evolve faster.
• Outdated pedagogy: Focus on rote learning, not problem-solving or practical application.
• Career unawareness:
  • 93% students (class 8–12) know only 7 career options (doctor, engineer, lawyer, etc.).
  • Economy actually offers 20,000+ career paths.
• Skills gap in graduates:
  • Only 43% graduates job-ready (Graduate Skills Index 2025).
  • 40–50% engineering graduates remain unplaced.
  • Even STEM students lack industry-required skills.

Impact of AI & Automation

• McKinsey estimate: By 2030, 70% of Indian jobs at risk from automation.
• World Economic Forum: AI may create 170 million jobs by 2030, but 92 million will be displaced → Net gain possible only with reskilling.
• Nature of change:
  • 30% of tasks in existing jobs → automated.
  • New opportunities in AI development, data science, robotics, cyber-security, green jobs.

Government Efforts

• Skill India Mission (2015): Target 400 million by 2022 → fell short due to poor monitoring, fragmented implementation.
• Other schemes:
  • PM Kaushal Vikas Yojana (PMKVY)
  • PM Kaushal Kendras (PMKK)
  • Jan Shikshan Sansthan (JSS)
  • PM Yuva Yojana (PMYY)
  • SANKALP, PM Internship Scheme
• Problem: “Acronym soup” of schemes, poor integration, low awareness, weak industry linkages.

Challenges in the Current Education System

• High school problem:
  • Lack of career counselling (only 7% get formal guidance).
  • Curricula exam-driven, not skill-driven.
• Higher education disconnect:
  • Degrees ≠ employability.
  • Employers face skill shortage despite mass graduation.
• Digital divide: Smartphones common, but teaching mindset remains analog.
• EdTech limitations: Focus on test prep, not skill development → certificates commoditized.

Risks if Unaddressed

• Demographic time bomb: Educated but unemployable youth → unrest & instability.
• Historical parallel: 1990 Mandal Commission student protests → violent unrest.
• Lant Pritchett’s “Where Has All the Education Gone?”: Education without employability leads to wasted human capital.
• Social contract under threat: Youth disenchantment can escalate into economic, political, and social crises.

Way Forward

• Curriculum Reform:
  • Integrate AI, data science, coding, green economy, critical thinking at school level.
  • Update cycle must be continuous, not once in 3 years.
• Career Guidance:
  • National framework for career exploration in schools.
  • Awareness of 20,000+ modern career paths.
• Industry–Academia Linkage:
  • Courses co-designed with industry (apprenticeships, internships).
  • National Skill Universities with strong private sector partnerships.
• Skilling Ecosystem Reform:
  • Merge fragmented schemes into one National Skill Grid.
  • Outcome-based measurement (placement %, not training numbers).
• Digital Integration:
  • AI-driven personalized learning platforms.
  • Expand access to rural areas through PM e-Vidya, SWAYAM, DIKSHA.
• Public–Private Collaboration: EdTech + Government + Industry partnerships for real-time skill delivery.
• Youth Empowerment Policy: Embed reskilling, upskilling, cross-skilling in National Education Policy (NEP).

Building health for 1.4 billion Indians

Background

• Health-care paradox in India:
  • Rising demand for affordable & accessible care.
  • Growing burden of non-communicable diseases (NCDs) (diabetes, hypertension, cancer).
  • Uneven distribution of services (urban vs tier-2/3 cities).
• Demographic reality:
  • Large, young population → increasing health needs.
  • Aging population by 2047 will further stress the system.
• Core challenge: Dual task of expanding access and ensuring affordability.

Relevance : GS 2(Health , Social Issues)

Practice Question : Insurance, prevention, and digital innovation are the three pillars for building a resilient healthcare system in India. Discuss.(250 Words)

State of Insurance & Affordability

• Insurance as foundation:
  • Pooling risk → shields families from catastrophic health expenses.
  • Even modest premiums (₹5k–20k individual, ₹10k–50k family) = several lakhs coverage.
• Current status:
  • Only 15–18% insured.
  • Insurance premium-to-GDP ratio 3.7% (India) vs 7% (global average).
• Potential:
  • $15 billion gross written premiums in 2024 → projected 20%+ CAGR till 2030.
• Problem:
  • Insurance mostly crisis-driven; not integrated with everyday care, outpatient needs, prevention.

Efficiency & Scale

• India’s unique model:
  • Extraordinary efficiency in healthcare delivery at scale.
  • Example: MRI machines → 7–8 scans/day in West vs many times more in India.
  • Rooted in: doctor-patient ratios, workflow innovation, infrastructure utilisation.
• Next leap:
  • Extend this efficiency to tier-2 and tier-3 cities (currently underserved).
  • If successful → India sets a global benchmark for affordable scale healthcare.

Role of Government Schemes

• Ayushman Bharat – PM Jan Arogya Yojana (PM-JAY):
  • Covers 500 million people.
  • Provides ₹5 lakh/family/year for advanced care.
  • Enabled millions of cashless treatments.
  • Example: Cancer treatments for beneficiaries ↑ nearly 90%.
• Need: Expand private hospital participation with fair reimbursements + transparent processes.
• Ayushman Bharat Digital Mission (ABDM):
  • Aims at universal health records → continuity of care across public + private providers.

Prevention as the Cost-Saver

• Rising burden of NCDs: Major share of OOP (out-of-pocket) expenditure.
• Punjab study: Even insured families → catastrophic spending on diabetes, hypertension, etc.
• Solution:
  • Insurance redesign → cover outpatient & diagnostics.
  • Nationwide prevention push → lifestyle, diet, screening.
  • Public participation → schools, employers, communities promoting preventive health.
• Logic: Every ₹1 spent on prevention saves multiples in future treatment costs.

Digital Transformation in Health

• Telemedicine & AI adoption:
  • Remote consultations (bridging urban specialists with rural patients).
  • AI tools → detect sepsis early, triage reports, optimise workflows.
• Impact:
  • Democratise access → reach rural & underserved.
  • Increase doctor productivity.
  • Enable universal digital health records (under ABDM).

Regulation & Trust

• Challenge: Rising costs due to environmental & lifestyle factors.
  • Eg: Insurers considering 10–15% premium hike due to pollution-linked respiratory illness.
• Importance of regulation:
  • IRDAI urged to strengthen claims settlement, grievance redress.
  • Trust is key → without confidence, households won’t buy insurance.
• Balance required: fair pricing + transparent processes.

Investment & Inclusion

• Private investment: $5.5 billion (2023) in health (digital, pharmacy, hospitals).
• Problem: Concentrated in metros.
• Way forward: Redirect capital to tier-2/3 cities, primary networks, training specialists.
• Outcome: Growth → inclusion, not just elite urban healthcare.

Risks if Challenges Persist

• Low penetration → continued catastrophic out-of-pocket (OOP) expenditure (~55% of health spending).
• NCD tsunami → overwhelming public + private health system.
• Urban-rural divide widens → inequity, social unrest.
• Trust deficit → poor adoption of insurance, loss of financial protection.

Way Forward

• Insurance:
  • Expand beyond inpatient → outpatient, diagnostics, preventive care.
  • Incentivise preventive behaviour (premium discounts for healthy lifestyle).
• Primary Healthcare Strengthening:
  • More Health & Wellness Centres (HWCs).
  • Focus on NCD screening.
• Digital push: Scale telemedicine, AI diagnostics, ABDM adoption.
• Public-Private Partnerships (PPP):
  • Private hospitals in PM-JAY with fair reimbursements.
  • Joint investments in tier-2/3 healthcare infrastructure.
• Workforce training: More doctors, nurses, allied health professionals, especially in rural India.
• Regulation: Stronger IRDAI framework for claims settlement & pricing transparency.
• Equity focus: Direct PE/VC flows to underserved geographies.