The ambitious plan to roll out healthcare coverage for 10 crore families will make it the world’s largest government funded healthcare programme, Finance Minister Arun Jaitley said in his Budget speech today.

High on the optics as it puts health on centre-stage, this announcement has already been labelled “Modicare” (a la Obamacare) on social media, with an eye clearly on election 2019. Unfortunately though, this proposal has a precedent. A social security proposal announced in Budget 2016 that did not take off for want of a roll-out plan and supporting fund allocation.

Jaitley’s flagship National Health Protection Scheme (Budget 2018) speaks of providing healthcare coverage to approximately 50 crore beneficiaries, providing them coverage of upto Rs 5 lakh rupees per family per year for secondary and tertiary care hospitalization. “Adequate funds will be provided for smooth implementation of this programme,” he had said.

But this is merely an expanded, repackaged version of the social security scheme of 2016 and even a rough calculation shows that it doesn’t add up, says Professor Indranil Mukhopadhyay, a health economist and Assistant Professor, OP Jindal Univeristy. “If we look at similar models and at half the market rates, the allocation the Government would need to pay just the premiums is about Rs 1.2 lakh crore and the country’s total spending on health is about Rs 1.3 lakh crore,” he said. There is no clarity on how this will be rolled out and who foots the bill, a plan that mirrors the confusion of the 2016 proposal. Even if it were to be rolled out through the RSBY (Rashtriya Swasthya Bima Yojna), the allocation for this scheme this year is Rs 2000 crore, he added.

And while FM Jaitley say the national healthcare protection scheme is a step towards Universal Health Coverage, Mukhopadhyay points out that past announcements on the UHC roll out also barely saw any follow-up action.

Gaps not addressed

While health is getting a mention in the Budget in terms of the 3000 Jan Aushadi centres that sell less expensive medicines or the Government’s initiatives to bring down the price of cardiac stents, there is little in it to address several other gaps affecting public health.

Shailaja Chandra, former secretary at the Health Ministry, is happy at the priority mention that healthcare is getting in the Budget in terms of an expanded health insurance or financial support of Rs 500 per month toward the nutritional of a person undergoing treatment for tuberculosis.

However, she adds, many of the initiatives don’t seem to be thought through. For instance, the gaps in public healthcare delivery in terms of staffing or the regulatory coverage of the healthcare prevention scheme. There needs to be greater focus on a preventive set up or a strengthening of the existing framework to tackle communicable diseases and to prevent more Gorakhpur’s from happening, she says, referring to the deaths of several infants at a Government hospital in Uttar Pradesh.

Insurance companies could end up reaping the benefits of the health coverage scheme, she says, calling for a regulatory mechanism to make sure they pay patient bills without delays.

With the Budget being high on making promises, the critical element now is how the Centre rolls out these initiatives, some of which have already stumbled in the past over inadequate funds.

jyothi.datta@thehindu.co.in

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