Funding is no issue for ‘Modicare’, says Nadda
NEWDELHI: “Budget is not an issue. Whatever, whenever we’ve asked (for health), we’ve (always) got it,” said Union health minister JP Nadda, dismissing concerns about budgetary shortfalls to fund the National Health Protection Scheme, the world’s largest health protection scheme that will offer insurance cover of up to ~5 lakh to 100 million poor families, with benefits expected to reach 500 million people. Some people are calling it “Modicare”.
“We don’t need to wait for all states to join in. Once our plan is ready, we will go forward,” said Nadda, in an exclusive interview. “The states will be the implementing agency, they will decide whether a trust or an insurance company (will run it). The Centre will ensure that it is a very robust system, highly digital, paperless and cashless and the benefit reaches the patient,” said Nadda.
NHPS was first announced in the 2016 Budget, but didn’t take off after consultations with states showed gaps in the scheme. In its first avatar, it offered R1 lakh annual health insurance cover, with a top up of R30,000 for senior citizens. “We have been working for the last two years. Initially, there was a R1 lakh proposal, but many states were already giving it. We discussed whether they should top up or run a separate scheme. We worked all that out and then came with this scheme,” the health minister explained.
The date for the launch will be announced after consultations with the Prime Minister, he added. “It will be rolled out this year, karna hi hai (it has to be done),” said Nadda.
“We’ve keep aside ~2,000 crore (for NHPS)but budget is not an issue. It is a commitment we will keep. That is how we function. The dialysis programme had no budget, but it now gets~900 crore every year,” he said.
In his budget speech, Finance Minister Arun Jaitley said India’s transformative national health protection scheme (NHPS) will take healthcare to a new aspirational level by offering insurance cover of up to ₹ 5 lakh to 500 million “poor and vulnerable” Indians. Raising the mediclaim cover by up to 17 times from the existing Rashtriya Swasthya Bima Yojana (RSBY) that caps it at ₹30,000 per year, the NHPS is expected to cover 40% of India’s population with a budgetary outlay of Rs 2,000 crore this year.
Is the budgetary allocation enough? JP Nadda, the Union minister for health and family welfare, assures Sanchita Sharma and
Shishir Gupta that budget is not an issue and there’s more to come when Modicare takes off.
When will NHPS be rolled out?
We have taken our experiences of RSBY (Rashtriya Swasthya Bima Yojna) to a mission mode. The appointment of a mission head will be done soon. It needs huge technical backing, so consultations with technical experts on aspects such as, what will be the safeguards, what will be the monitoring system etc are being finalized. We are ready to roll out. After consultations with the PM, we will come out with a date. It will be rolled out this year, Karna hi hai (it has to be done).
Have all the states with state health insurances schemes agreed to merge them with NHPS?
It’s up to them. The consultation process has started, we are talking to all states and we are trying to see whether their schemes can be subsumed or if they want to go separate.
It’s up to them what models they are adopting, whether it is a trust model or a (private) insurance model. They will choose how they want to roll out with us. These are the aspects of the consultation going on with all states.
Is there a model proposal?
There is no model proposal. Whether it is a trust or an insurance company implementing Modicare, the states will decide. We will support whichever model works best for them. They have to opt and we will support them. States will be the implementing agency. We will see to it that it is a very robust system, highly digital, paperless and cashless and the benefit reaches the patient. We have designed a different structure. It will work very independently.
What is the role of the private sector?
The National Health Policy 2017 talks about the “strategic engagement of the private health sector”.
For example, free drugs and diagnostics that should be given but are not available in a public sector can be procured from the private sector at our rates.
Will you wait for all states to join?
We don’t need to wait for all states. Once our plan is ready, we will go forward.
Will we see GSTlike consultations?
As the states join in, we will develop a structural mechanism to see that it works smoothly. Unlike GST, which is the same for everyone, here states will come out with different proposals. So X state may not be using the Y state model.
Has any state agreed to come on board yet?
No, the consultation is going on; the secretary, health is chairing it.
Will oppositionruled states come on board?
Yes. This is not about BJP or Modi. It is Modiji’s commitment, Modicare, for the common man and it has to reach the common man.
What was the PM’s role in this?
He was fully involved in guiding and discussing shortcomings. (He was concerned about) how will it reach everyone? What methodology will be used? There were several presentations on that. It’s not just for the BPL, it’s for “poor and vulnerable”, which raised the number of those covered from 4 crore to 10 crore families.
What is the ballmark budget for NHPS when it fully rolls out?
Whatever it takes, we are committed to it. It’s demand-driven.
As people start joining in and as things roll out, the budget provisions will be increased. (The budget) will increase as more and more states join in and that will determine the premium. We have keep aside 2,000 crore (for Modicare) but budget is not an issue. It is a commitment we will keep. That is how we function.
The dialysis programme had no budget, but it now gets R 900 crore every year. It took a full year for it to roll out. Districts needed machines, private players had to come in, MoUs had to be signed, not with us but with the district hospital—it all took time but today 2.21 lakh patients are on dialysis, more than 11 lakh sessions have happened at public facilities..
The opposition wants to know where the money will come from.`
Their job is to dilute the issue. If they were serious about the issue, they would have wanted to know how it will reach patients. If they had asked whether there will be insurance model or trust model, which one is successful, which is not… study to koi karta nahin hai (no one studies the issue). They just want to oppose.
When the prime minister has made a commitment, then it is a financial commitment and we’ll do it.
When did work on Modicare begin?
We have been working on it for the past two years. Initially, there was Rs 1 lakh proposal, but many states were already giving it. We had consultations on whether they would like top up or run a separate scheme. We worked all that out and then we came with this scheme.