No other government plan has, perhaps, divided opinion in recent years as much as the National Health Protection Scheme (NHPS). A plan that seeks to universalise health insurance in India is a big step for the simple fact that only 28.7 per cent of households in the country have at least one member covered either under health insurance or a health scheme.
The National Family Health Survey 2015-16 which reveals this fact also shows a huge gulf in the health insurance coverage map. Out of the 36 states and union territories, just 14 score above the national average. Andhra Pradesh stands at the top with 75 per cent coverage while Lakshadweep is at the bottom. The southern states, barring Karnataka, surge ahead of the rest of the country. Even Chhattisgarh and Odisha fare well. Seen through a political lens, the survey shows that big BJP-ruled states including Maharashtra, Madhya Pradesh, Gujarat, Rajasthan and Uttar Pradesh are laggards on this count. In a country where health outgo drills a big hole in the pockets of the economically weaker sections, expanding insurance coverage makes sense.
The total out-of-pocket-expenditure on health by households stands at `3.02 lakh crore, which is 62 per cent of the total health expenditure. No wonder, absence of insurance cover pushes the poor into a vicious circle of low productivity and further penury. In such a scenario, the NHPS brings hope but the jury is still out on the source of funding, burden of premium and how states implement it since they will have an equally significant role.
However, NHPS is not the panacea India seeks. Currently, over 55 per cent households do not opt for government health facilities because of poor quality of care. This trust deficit needs to be tackled through improved public health infrastructure that requires more investment. India’s public health expenditure is just 1.4 per cent of the GDP. And going by the current rate of growth, achieving the National Health Policy 2017 target of 2.5 per cent by 2025 looks a tall order too.