State of the Union
On February 1, 2018, the finance minister during his Budget speech declared, “I am pleased to announce two major initiatives as part of ‘Ayushman Bharat’… We will launch a flagship National Health Protection Scheme to cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to `5 lakh per family per year for secondary and tertiary care hospitalisation. This will be the world’s largest government funded healthcare programme. Adequate funds will be provided for smooth implementation of this programme.” The whole House applauded the initiative.
However, when the Budget documents came in, there was no elucidation of how the announcement would be implemented. Even the amount that was earmarked for the project was only `2,000 crore. It all did not add up. How come such an ambitious programme had been announced in the Budget without a scheme to back it up? Then, as the day wore on, in the incessant cacophony of TV analysing the Budget to death, it emerged that a scheme had to be formulated as yet though some of the “babus” of the government, who also masquerade as spokespersons of the ruling dispensation, attempted to spin the embarrassment by claiming that some work ostensibly had been done on it.
A reputed financial journalist, M.K. Venu, tweeted a rough back-ofthe-envelope calculation of the cost of the programme. He said and I quote, “Obamacare healthcare subsidies covering 26 million families was estimated to cost $42 billion in 2017. Modicare covering 100 million families allocates $300 million! Even assuming healthcare in India costs one-tenth of US, Centre will still need at least $15 billion a year!”
Decoded and translated into Indian numbers it means that, Obamacare, a health insurance programme in the United States that President Donald Trump has desperately tried to repeal and has been unsuccessful so far and thank God for it for it is a good noble programme, in the year 2017 alone would roughly cost about `3 lakh crore for covering 2.6 crore families. The Indian programme in the Budget, that would cover 10 crore families, has an allocation so far of only `2,000 crore. Assuming that the healthcare costs in India are one-tenth of the US, the programme would still roughly cost about `1 lakh crore to implement.
The national convener of the Jan Swasthya Abhiyan, Dr Abhay Shukla, was quoted in a newspaper as saying: “If the allocation is meant for 50 crore people, then the premium works out to `40 for each.”
After brouhaha for two days that the emperor announcement of the Budget does not seem to have any clothes, source-based reports quoting some unnamed officials appeared in newspapers suggesting that the health plan would be funded in the ratio of 60:40 between the Centre and states and may be rolled out nine months down the line, on October 2. Various guesstimates by various officials have pegged the quantum of funds required to implement the scheme at a ridiculously low number. However, the fundamental point remains that if the proposed health insurance plan