Topic 1: Why did Google delist some Indian apps from Play Store?

Why in news?

• On March 1, Google announced that it was pulling the apps of almost a dozen firms out of its marketplace for Android apps.

What is the problem?

• At the heart of the issue are Google’s platform fees. A fee of anywhere between 11 to 30% per transaction is collected by Google for all in-app purchases involving a purely digital service, such as an e-book purchase or an OTT streaming subscription.
• This fee, according to Google, helps pay for Google Play and develop the Android ecosystem. The exact fee paid by each developer varies, depending on the company’s revenue from in-app payments. However, these fees are seen as a high price to pay by Indian developers, similar to many global counterparts.

What about other marketplaces?

• Similar pushback has not been experienced by Apple in India, primarily because fewer Indians use its products compared to Android. Android dominates the smartphone market, and Google Play is widely perceived as the top choice for developers seeking consumer discovery. Nonetheless, both Apple and Google have encountered significant international resistance to their fees, and both companies have strongly countered developers’ resistance efforts.

How have regulators responded?

• The Competition Commission of India (CCI) had in 2022 fined Google ₹44 crore for its Play Store policies. The company is in the process of appealing that fine, as well as orders by the CCI that it give developers comprehensive choices for in-payments. An appeal by Google against this fine is pending at the National Company Law Appellate Tribunal.
• Meanwhile, the Indian apps that went to the Court are back on the platform for now. In-app payments are not yet a major part of the digital economy in India, as purely digital services for which Indian consumers have been willing to pay have been limited to content streaming, dating and matrimonial services — the very segment that is largely up in arms against Google’s fees.

Topic 2: Healthcare Centers

Why do health centers matter?

Health centers, the lowest rung of India’s public health system, are tasked with providing accessible and affordable primary care.

Numbering almost two lakhs, they are structured as a three-tier system:

1. Sub-Centers (renamed as health and wellness centers)
2. Public Health centers
3. Community Health centers

• While 94% of these centers are situated in rural areas, reports indicate that less than 20% of them operate effectively, compelling disadvantaged communities to resort to expensive, exploitative private healthcare.
• According to Economic Survey of 2023-34, nearly half of all health spending in India is borne by patients themselves due to the absence of proper insurance and affordable services. This situation often drives many households into poverty.

What has changed in last two decades with respect to functionality of Health Care Centers?

• As per study of Health Centers by Jean Drèze between 2002 and 2022, there is on an average, contrary to popular belief, there is “evidence of functionality” across PHCs.
• The share of health expenditure in the Union Budget has experienced a significant increase, particularly with the introduction of the National Rural Health Mission. India’s flagship Ayushmann Bharat programme, launched in 2018 with the goal of achieving universal health coverage, introduced a health insurance component known as PMJAY (Pradhan Mantri Jan Arogya Yojana) and a public provision component through health and wellness centers (HWCs).

What are the challenges and persisting problem still plaguing the health care centers?

• The centers continue to be “grossly underutilized,” characterized by high staff absenteeism, low daily patient numbers, limited services, and likely poor quality of services.
• In Bihar, sub-centers remain entrenched in old practices where Auxiliary Nurse Midwives (ANMs) primarily concentrate on family planning targets and persuading people, especially women, for sterilization.
• As per the report the challenges enlisted by the health workers were aplenty and basic such as:
  • Lack of Staff
  • Irregular Flow of Funds
  • Lack of Toilet Facilities
  • No Transport or Residential Facilities
  • Lack of Drugs or Functional Testing Equipment
  • Growing Burden of Online and On-Field Work

What are the social discriminations affecting the health centers?

• Care isn’t offered in a vacuum devoid of social realities; identity markers like caste, class, gender, and religion have historically shaped Indians’ access to health services.
• Social Discrimination in Health Centers:
  • Some upper-caste doctors exhibit disparaging attitudes towards marginalized communities.
  • Upper-caste families frequently disrespect Dalit Auxiliary Nurse Midwives (ANMs).

Influence of Identity Markers: Access to healthcare services in India is influenced by identity markers such as caste, class, gender, and religion.

• Historical patterns indicate that these identity markers have shaped Indians’ access to health services.
• These points highlight the social complexities and challenges within India’s healthcare system, emphasizing the need for addressing social discrimination and promoting inclusivity in healthcare delivery.