That healthcare has become a politically hot commodity leading to formulation of an ambitious health coverage scheme in a pre-election year is both telling and encouraging. It reflects the recognition among the political class and policymakers that lack of access to healthcare has become a major sore point for Indians, with rising healthcare costs being a cause of indebtedness. The pinch is felt across the socio-economic divide.
The scheme reflects recognition that in the face of sustained advocacy by activists for many years, the government has finally acknowledged the need to pay adequate attention to putting in mechanisms for tackling the devastating effects of health expenditures. The scheme aims for an initial focus on 50 crore beneficiaries. However, even this would take some time, with teething troubles in the pilot period.
Dedicated adequate funding for the scheme is still uncertain, though the government has expressed its intention to find the necessary funds. The fact that the scheme would run on a strong IT backbone is a positive as it would aid in efficiency and better governance.We have had a long history of government health insurance programmes and the scheme leadership would do well to learn from the best practices and failures of these schemes. It should also be flexible in its qualification criteria so that the most vulnerable are not excluded.
A major lacuna in the scheme is its overt focus on just in-patient treatment, though a significant proportion of health expenditure for families is in out-patient consultations, costs of medications/devices, out-of-pocket expenses such as travel for seeking healthcare, loss of associated daily wages etc.
(Anant Bhan is a researcher in global health, health policy & bioethics & Adjunct Professor at Yenepoya Mangaluru)