In the 2018 Union budget, Finance Minister Arun Jaitley announced an ambitious plan to provide free health insurance to 11 crore poor families. This scheme is also being termed as the world’s biggest public-funded health insurance plan. The announcement raised a few questions with respect to its implementation. In the current budget India’s finance minister did not allocated any fund for so called “Modi-care” later on it admitted that implementation of this scheme is not possible without help of all state government. Is this viable to provide health cover to poor at such a large scale when the world is already try to find out a way to cope-up the stiff trade war between United states of America and rest of world. The grim picture is India’s rupee is at its lowest point and all these things directly or indirectly affects all the ambitious project and its smooth implementation.
India’s Ministry of health and family welfare will implement the “Ayushman bharat” National health protection mission (AB-NHPM) the plan seeks to extends health insurance to 500 million people from financially weaker section of population. It is estimated that 4 out of 10 Indians would have direct access to high class facility of modern medicine ,critical care and quality tertiary care through private and public sector hospitals in India. This will provide insurance cover of 5 lakhs per family per year. Ensuring nobody is left out in the family there is no cap on family size or age in the scheme. At present it would not be rolled out nationwide at present pilot project in around 80-100 districts of Haryana, Uttarakhand and Chhattisgarh.
Out of 36 states and union territories, 28 are already on board out of them Tamil-nadu has already state run health insurance scheme. There are state government who are reluctant to join the scheme as this will require huge budget allocation.
The initial allocation for the project was 2,000 crore however it was enhanced to 4,000.It is expected that when the scheme will be running in full capacity it will require around 20,000-30,000 Crore of that more than 50 percent has to come from Central government of India. Total expenditure will depend on the actual market determined premium paid in the state and union territories where the scheme will be implemented through private insurance company.
It is important to before implementing the scheme nationwide, strengthen primary healthcare system, all the primary hospital at the district level should be equipped with proper infrastructure. There is also need of connecting new medical collage to district hospitals and sub-district hospitals. India also requires doctors at village level so it is also advised to have incentive package for doctors.
The first phase involves only public hospitals, however discussion between government authorities and private giants are in last leg. The latest scheme is the biggest since the government decided to insure farm output to mitigate the risk involved in all kinds of crops. It is estimated that once the scheme is running in full swing it will require new private hospitals to caters the needs of patient even in rural parts of the country because they will also be covered under insurance scheme. If implemented properly it will make the project a great success.
Many countries have rolled out healthcare insurance scheme. Countries with high per-capita income have employee deductions and cover a large population under the universal health scheme. We have precedent of Obamacare which failed miserably as population at large were not able to get benefits and insurance companies were charging higher premium which led to repeal of Obamacare.
Government has put the spotlight of political attractive policy announcement on health and for it to be successful, New-Delhi needs to strengthen primary healthcare and learning from the failure of Obamacare it should be drafted properly to ensure optimum utilization of resources with effective management. It is an ambitious scheme, people will get into debt-trap if the scheme is not materialized and implemented effectively as the main focus is on the economically weaker section of population. We need to have proper negotiation between hospitals and government, have a robust technology to measure the quality of procedure implemented at grass-root level, it can ensure successful scheme and eventually it will also help in up gradation in standard of living of economically weaker section