There is much hue and cry over the Government’s recent decision to make Covid tests payable. But the Health Department has now clarified that all high risk and primary contacts would be tested free of cost as this is the responsibility of the state, as laid out by the Supreme Court in April this year. What the Government is trying to do is to stop making testing at the entry points free since people who enter Meghalaya for purposes of business or are central government employees are capable of paying for their tests.  At 4,500 rupees for an RT-PCR test it is quite a steep ask. The Supreme Court in a new order dated April 13, said that government would reimburse private labs for testing the 500 million people covered by a flagship public health insurance scheme while the rest would have to pay. But the bigger question is whether India can scale up testing for Covid-19 if it’s not free, especially now that the numbers are going up?
But scaling up is a challenge. The sheer size of India’s population, and the resources needed to reach every corner of the country, is daunting. All of this has made testing expensive. It’s free at government hospitals and labs – and for months they were the only ones permitted to even test for coronavirus. But soon private players were roped in to support India’s underfunded and struggling public health system.
In the case of Meghalaya and of other states too if testing were to be made payable then the number of people who would come for voluntary testing after having been in contact with a primary or secondary sources would drop down and such people could become silent carriers. This should be the biggest worry for the government. As of now those being asked  to be tested because they are high risk contacts don’t have to pay for the tests.
Economist Jayati Ghosh says if a country needs to contain a pandemic the testing cannot be determined by cost. Other economists are of the view that making the test free only for the poorest Indians doesn’t help either because there’s a big chunk of people just above the poverty line that are also struggling and there are middle-class workers who have been laid off and can’t afford to pay for their families to get tested. More importantly, the asymptomatic nature of the virus in many people means that India may soon have no choice but to begin mass testing. And if India needs to push up testing rates it cannot expect everyone to pay from their pockets, especially if they are asymptomatic.
It is on these lines that the Government of Meghalaya needs to proceed.
