THE CONSTITUTIONAL DUTY TO HEALTHCARE IN INDIA: LEGAL ARCHITECTURE, ACCOUNTABILITY AND PATHWAYS TO UNIVERSAL HEALTH COVERAGE

Abstract

Healthcare is increasingly recognised as an integral component of the right to life and human dignity under Article 21 of the Constitution, yet the translation of this judicial recognition into effective health outcomes remains inconsistent. India's health system continues to face insufficient public financing, fragmented regulation, over-reliance on private providers, and significant inter-state disparity in access and outcome. This paper examines the constitutional duty to healthcare in India through a legal and institutional lens, analysing the normative foundations of the right to health, the evolving role of the judiciary, and the adequacy of the existing legislative and policy framework in advancing Universal Health Coverage. It evaluates flagship initiatives, including the National Health Mission, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana and the Ayushman Bharat Digital Mission, and identifies persistent accountability deficits in financing, regulation and service delivery, including in the largely unaddressed area of digital health data governance. Drawing on comparative experience from Thailand, South Africa and Brazil, the paper argues for the recognition of a legally enforceable minimum core health entitlement under Article 21. It concludes by proposing institutional and statutory reforms directed at strengthening accountability, ensuring equity, and enabling a phased but genuinely enforceable pathway toward Universal Health Coverage in India.