Tuesday, 13 February 2018

Ayushman Bharat health insurance will cover 50 crores Indians in just Rs 12,000 crores

Hospitals in India
Saifee Hospital, Mumbai

Ayushman Bharat aka ModiCare will be the world's largest government-sponsored health assurance scheme.

How much does it take to cover almost 50% of India's 'mammoth-size' population? Not much, actually. The useless debates on the Indian media and the over-estimation by India's weak opposition would have come to halt if both of them would have done some basic research. Forget research, most of these daily debaters didn't even invite insurance experts on the panel. Although the budget 2018 brings a ray of hope for farmers and India's poor, Indian media was disappointed with little changes in tax slabs. Some sections of Indian media being completely clueless starting calling Ayushman Bharat as 'a hoax to win votes'.

Swasth Bharat = Saksham Bharat

The general budget 2018-19 was aimed at making path-breaking interventions to address health holistically, in the primary, secondary and tertiary care systems, covering both prevention and health promotion. 

The initiatives are as follows:-  

Health and Wellness Centre:- The National Health Policy, 2017 has envisioned Health and Wellness Centres as the foundation of India’s health system. Under this 1.5 lakh centres will bring health care system closer to the homes of people. These centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services.  These centres will also provide free essential drugs and diagnostic services. The Budget has allocated Rs.1200 crore for this flagship programme. The contribution of the private sector through CSR and philanthropic institutions in adopting these centres is also envisaged.

National Health Protection Scheme:- The second flagship programme under Ayushman Bharat is National Health Protection Scheme, which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to 5 lakh rupees per family per year for secondary and tertiary care hospitalization.  This will be the world’s largest government-funded health care programme. Adequate funds will be provided for smooth implementation of this programme.

The National Health Protection Scheme aka 'ModiCare' will be the world's largest government-sponsored health assurance scheme. The much-appreciated ObamaCare in the US had approximately 30 crore enrollees. The United Kingdom through its National Health Services offers free healthcare to its 10 crore ordinary citizens at public hospitals. The 2017 UK budget allocated 6.3 million pounds for spending in NHS. India's newly announced NHPS will cover all of India's 50 crore poor citizens at the public as well as the privately operated hospitals.

'ModiCare' will cover nearly 50% of India's population is just Rs 12,000 crore

Insurance experts firmly believe that India's 10 crore poor families can be covered in just Rs 12,000 crores. Since healthcare is a state subject, 50% of the cost of premium will be borne by state governments. Rs 6,000 crore annually, from the central government is a small amount of India's 25 lakh crore general budget. As India grows, the 'ModiCare' scheme is likely to be expanded to all of its 128 crores + citizens and later we be can even be linked with retirement benefits, like the one's offered in ObamaCare. Currently, only 5% of India's population is covered by a health insurance.

Health insurance for India's poor is a not an initiative, as India's weak united opposition said. The Rashtriya Swastha Bima Yojana covered most of the blue-collar workers with Rs 30,000 year. The newly announced NHPS has been a talk-of-the-nation as Rs 5 lakh per year is enough to treat life threating diseases like cancer or cardiac illnesses. Various states in India have announced health insurance scheme but only Rajasthan's mass health coverage scheme comes close to 'ModiCare'.

Rajasthan's Bhamasha Swasthya Bima Yojana, tendered in December 2017, will cover nearly 4 crore poor people of Rajasthan state. The project of Rajasthan's state-sponsored insurance was bagged by New India Assurance Ltd. This is one of the largest health insurance schemes in the country as it gives health cover for cashless treatment of 1,401 diseases - of Rs3,00,000 for 663 critical and Rs30,000 each for 738 general illnesses. The total insurance premium involved in Bhamasa Swasthya Bima Yojana is more than Rs1,200cr per annum with the State bearing Rs. 1,261 per family.

As the spread increases in insurance, the premium is expected to lower further. Rs 1,261 per family in Rajasthan could be reduced further to Rs 800 to Rs 1,000 per family in India. The tenders for NHPS are likely to be announced in Q1 2018 and the L1 bidder (that is the lowest bidder) for each state or tehsil will be selected. It is utmost important to maintain actuarial price for the successful implementation of this mammoth-sized project. This is India's golden chance to improve the standard of living of its poor citizens. With the demand for qualitative healthcare in small cities, the supply of multi-specialty quality hospitals are expected to reach the length and the breadth of this country. 

According to TheIndianCapitalist.com, the economies of scale and scope can do wonders for India. It is a humongous task, a case study for the world to achieve Sustainable Development Goals by the Year 2030. With the sincerity of purpose, honesty and giving-it-back attitude, India will be successful in this project. It's much appreciated that India's powerful man, the Prime Minister, is committed towards his duty towards Right to Qualitative Healthcare.

- Chaitanya Kulkarni


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