India’s Ayushman Bharat: The largest health scheme in the world

By Anushree Jois

At a news briefing this Thursday, the Health Minister, JP Nadda, stated that the government is set to allocate 100 billion Rupees ($1.54 billion) for its ambitious health programme, the Ayushman Bharat– National Health Protection Mission. Being dubbed as the largest public health scheme in the world, it is expected to be funded by both the central and state governments every year.

Allocation of funds

Earlier this year, the Finance Minister, Arun Jaitley, had introduced the health scheme in the Union Budget saying that it would cover 500 million of the country’s poorest people. An allocation of 20 billion rupees had been made for the financial year 2018-19.

Thursday’s statement by the Health Minister indicates an increase in the allocation to 100 billion rupees, for the financial years 2018-19 and 2019-20. The funding, therefore, for 2018-19 has effectively increased by 30 billion rupees for 2018-19 and is expected to receive more funds, if needed. The scheme has also received the approval of the union cabinet and awaits implementation.

Floating of the scheme

Becoming popular by the title of “Modicare”, it is latest in the line of many reforms that the Modi government has rolled out. It aims to provide health cover to 100 million families or about 500 million poor and vulnerable people, which is close to half the population of India. The total health cover is proposed at Rs 5 lakhs per year for secondary and tertiary care and aims to reduce hospital expenses.

The scheme envisages joint funding by both the central and state governments, wherein the former would bring in 70 percent of the funds, leaving the remaining 30 percent to be brought in by the latter. It is also being reported that the major government health insurance companies have agreed to join the bandwagon. Additionally, the newly imposed one percent health cess on taxable incomes is also expected to contribute towards funding the corpus.

Ensuring proper implementation

By the end of July 2018, the scheme is expected to become operational all over the country. The Health Ministry is entrusted with the task of ensuring that the logistics are worked out with all state governments, including training provisions, awarding tenders and finalising treatment packages. Meanwhile, the ministry is also working with the Rural Ministry to identify true beneficiaries for the scheme.

As the scheme is expected to be implemented by a new central agency, namely, the ‘Ayushman Bharat’- National Health Protection Mission Agency, the ministry is expected to ensure it is fully operational as well by the deadline.

Benefits to the poor

While speaking of the scheme, the Health Minister stated that “This will give underprivileged families the financial support required when faced with illnesses requiring hospitalisation.” Health expenditure is one of the major causes of poverty in India. It is seen that close to seven percent of the population is pushed into poverty every year due to healthcare expenditure. The scheme is expected to bring in price-checks as well.

Several state-initiated healthcare schemes have proved to be ineffective due to the lack of coverage, quality and high costs. In comparison, the new scheme boasts of a magnum corpus and a well-planned implementation.

Infrastructure and high expenditure

While the government is immersed in implementing the new scheme, other existing problems in the healthcare sector cannot be ignored, namely, the lack of hospitals, infrastructure and doctors. To tackle these issues, the union cabinet has also approved the continuation of the existing National Health Mission, focused on providing infrastructure and resources to public healthcare. The Mission has received a separate allocation of Rs 85,217 crore. The government, however, also has to ensure an effective utilisation of these funds.

Critics continue to oust the scheme as a sham and a publicity stunt to garner support from the rural areas. Also, while private healthcare sector has shown its enthusiasm, there is a fear that it would gulp down the funds flowing out of the public healthcare scheme, facing no competition at all from the public healthcare sector.

The way forward

India currently spends only about one percent of its GDP on public health, which is amongst the world’s lowest. Clearly, any move by the government to increase its focus and effective utilisation of funds is welcome. The government appears to have in place a well-drafted plan and is undertaking measures to implement the scheme in the coming months.

While being aware of its strengths, it also has to be aware of the loopholes in the present scheme and needs to brace itself to handle issues effectively. It has to ensure that the scheme proves beneficial to those who are in an actual need of the assistance.  The new scheme is indeed an unprecedented move and only time will tell of its effectiveness.

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