BENGALURU: Touted as the world’s largest government-funded health care programme, the National Health Protection Scheme seeks to cover 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to Rs 5 lakh per family per year for secondary and tertiary care hospitalisation.
However, the question remains: Which ‘poor and vulnerable’ families will get insured? Dr Rathan Kelkar, director, National Health Mission Karnataka, said, “According to the Food and Civil Supplies Department data, in Karnataka, 1.13 crore families are below poverty line. However, under the Rashtriya Swasthya Bima Yojana, under which the unorganised sector is covered under 10 categories of deprived, there are only 62 lakh families. These families used to get Rs 30,000 per family and now they will get Rs 5 lakh for secondary and tertiary care.”
Nandita Suneja, director, Global Health Strategies, said, “The scheme was first announced in the 2016-17 budget. Low levels of government expenditure — 1.4 per cent of GDP is spent on health — combined with low coverage rates for health insurance (less than 20 per cent coverage in rural and urban areas), means that individuals bear most of the cost of health care consumption through out-of-pocket payments at the point of service. Implementation details for the now-announced scheme are awaited.”Experts say the health system’s focus on health insurance comes at a cost of habitually abandoning health promotion — the control of the causative factors of these diseases.
Dr Giridhara R Babu, Additional Professor, Public Health Foundation of India, Bengaluru, said, “First, people with high-risk lifestyle can now enjoy the new health insurance, without quitting the risky behaviour. Instead of persuading a smoker to quit or an obese person to get active, insuring them for heart attacks and strokes is facile. Second, high blood pressure is in epidemic proportions. The budget does not propose new measures for early diagnosis or timely treatment for high blood pressure; however, one can get treatment when they suffer a heart attack or stroke.”
STATE TO HAVE 571 HEALTH AND WELLNESS CENTRES
In 2017, Rs 1,200 crore was announced for the National Health Policy, which, with 1.5 lakh health and wellness centres (HWC), seeks to bring health care closer to people. Unlike a primary health centre, a health and wellness centre has a mid-level health practitioner who can do preliminary diagnoses of ailments. Karnataka already has 105 HWCs, and now the 466 sub-centres will be upgraded and hence, in all, there will be 571 HWCs. Suneja said, “Health sub-centres, the lowest rung of the National Health Mission structure, will, for the first time, move beyond providing antenatal and postnatal care such as vaccinations. It will provide free essential drugs and diagnostics to the people.”