Will world's largest health insurance scheme benefit the poor?

Unprecedented Budget makes India and BJP proud L K Advani

L K Advani said “The budget combined “ambition and empathy” of almost an unprecedented order.”

"We are going fast on it", he said, adding that the government is committed on it.

The medical insurance is an important vertical of the healthcare sector.

The real challenge before the government now is to make the huge programme work, especially since a recent CAG report had disclosed the lack of adequate medical facilities & trained human resources and non-utilisation of funds.

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The National Health Protection Scheme to provide 10 crore poor and vulnerable families sounds promising. All of these mean that the existing shortfalls in public health and primary care facilities - 20 per cent shortage of health sub-centres, along with 22 per cent and 30 per cent shortage of primary health centres and community health centres (as per Rural Health Statistics 2016) - is unlikely to be addressed. The best way to generate productive talent is by adopting apprenticeship. For the first time, the government has focused on the needs of a health protection system. As mentioned earlier, the only line from Jaitley on fund allocation was that "adequate funds will be provided for smooth implementation of this programme".

The Healthcare Budget 2018 is ground breaking and will transform the Healthcare industry thus giving it a further boost. Merely starting more medical colleges will not ensure availability of doctors in rural areas as numerous fresh doctors are not willing to serve in rural areas despite a bond taken from them.

Leaving the individual taxation slabs and rates untouched, Jaitley in his last full budget before the 2019 elections proposed to reintroduce a standard deduction of Rs 40,000 for salaried tax payers in lieu of present exemption of transport allowance and reimbursement of miscellaneous medical expenses that will involve a revenue sacrifice of Rs 8,000 crore to benefit 2.5 crore people.

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Several state government has their own health care schemes but they are generally small or poorly implemented.

A fact check reveals that the scheme is too good to be real. This move coupled with the announcement of 24 additional government medical colleges and hospitals gives healthcare the centre stage in this budget. That is good news because, according to National Health Accounts, 2014-15 (NHA 2014-15), 62.6 per cent of the country's total health expenditure was OoPE by households, (Rs 302,425 crore), for the year 2014-15. However, this should also have given coverage on ambulatory, OPD and preventive healthcare basis which would have more comprehensive.

Sunita Narain, Director General, Centre for Science and Environment (CSE), while referring to the new health protection scheme said it must be acknowledged that this significant measure might make healthcare accessible to some of the poorest in the country - provided it reaches them. While the details of the scheme are not yet known, if implemented thoughtfully, it has the potential to significantly change the health indices of the country. The Budget also proposed starting a statewide ambulance service e-network similar to ride-hailing app Uber.

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However, beyond the anecdotal evidence of Indian healthcare's poor state, what are the hard figures that have prompted the government to opt for a programme entailing such an expenditure? As the scheme expands, the official said, the available funds to support the scheme will increase through the Centre's and state contributions and the money from the 1 per cent cess.

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