PM launches world’s biggest health scheme

Ayushman Bharat to cover 500mn poorPrime Minister Narendra Modi yesterday launched the world’s biggest health insurance scheme, promising free coverage for half a billion of India’s poorest citizens ahead of national elections next year.The bottom 40% of India’s 1.25bn people will be covered under the flagship programme, dubbed “Modicare”, unveiled in the federal budget earlier this year.The 100mn lowest-income families will be provided Rs500,000 ($6,900) in annual health insurance to treat serious ailments.Modi handed medical cards out at the launch of Ayushman Bharat - Pradhan Mantri Jan Aarogya Yojana scheme in Ranchi, capital of the eastern state of Jharkhand, calling it a historic day for India.“We want to strengthen the hands of the poor and stand shoulder to shoulder with them in pursuit of good health,” he posted on Twitter.The insurance cover was for treatment and care in hospitals but also covered medication and other costs for three days before and 15 days after, Dinesh Arora, deputy chief executive officer of Ayushman Bharat said.More 8,735 hospitals, both public and private, have been empanelled for the scheme so far.“No other nation has such a scheme...it will become an example that people will study all over the world,” Modi said.Without taking names, Modi used the occasion to target the Congress for “using schemes for the sake of vote-bank politics”.“Since long, we have been hearing the slogan of ‘gareebi hatao’ (abolish poverty) but they only indulged in politics of poverty, politics of vote bank. They were only giving out freebies to the poor instead of empowering them.“Previous governments’ schemes were guided by vote bank, with the beneficiaries selected on the basis of potential vote bank for them. But we strive for the empowerment of the poor.We believe in inclusive growth. The scheme is not aimed at benefiting a particular region or community or caste. It is for all, for the poorest of poor. The poor don’t want freebies, they have self-respect and seek empowerment. We work for their empowerment,” he added.The scheme is expected to cost the central and 29 state governments $1.6bn per year in total.Funding will be increased gradually according to demand.India’s overburdened public health system is plagued by a shortage of facilities and doctors and most people use private clinics and hospitals if they can afford to.But a private consultation can cost Rs1,000 ($15), a huge sum for millions living on less than $2 a day.More than 60% of the average family’s spending goes on medicines and healthcare, the government estimates.Many of the poorest just go without care.A report published this month by The Lancet medical journal found substandard healthcare was responsible for an estimated 1.6mn deaths a year in India – the highest anywhere in the world.Critics have questioned how the government plans to fund such an enormous safety net, and suggested it was little more than a sop ahead of elections next May.Modi will be seeking a second term on a platform of pro-poor policies and “Modicare” is a key plank of his pitch to low-income Indians.“This is going to be another scam. It will benefit only private insurance companies. The citizen of the country will realise later that it is nothing but an election gimmick,” said Congress leader Sanjay Nirupam .But K K Aggarwal, a cardiologist and former president of the Indian Medical Association, said “politicking over the scheme should stop”.“It has been launched, and it is going to be a game changer,” he said.Some healthcare providers have raised concerns about being left out of pocket, fearing the government has underestimated the cost of certain treatments.Prathap Reddy, chairman of private hospital chain Apollo Hospitals, said the private sector was “rightly worried” about pricing and reimbursements.“While we all work together to ensure the success of this scheme, there are areas that need focus and fine tuning,” he said.Others say it should have included primary day-to-day healthcare instead of just secondary and tertiary care for more serious and long-term treatment.“Modicare does not extend to primary healthcare, which, we believe, is the weakest link in the provision of public health in India,” Rajiv Lall and Vivek Dehejia of the IDFC Institute think-tank said in a column for the Mint newspaper.