Modi trying to stretch health care to masses
Initiative to extend coverage to 500M hits Indian hurdles
Prime Minister Narendra Modi’s plan to provide health insurance to a halfbillion Indians — a mass of people larger than the population of South America — before he seeks a fresh mandate next year is facing serious hurdles.
Almost five months after announcing the ambitious program, the government is still working to lock in hospitals and insurance companies in time for its planned August launch.
It aims to cover the poorest 40 percent in a country where a 2017 World Health Organization report found spending on health pushed more than 52 million people below the poverty line.
Fighting against accusations from the opposition Congress Party and other political groups that it’s friendlier to business than the poor, Modi’s government is also keen to shore up public support and roll out the program before the federal election in 2019.
Although beneficiaries have been identified and the IT infrastructure has been put in place, the involvement of hospitals — public and private — and insurance companies was still to be finalized, said Indu Bhushan, chief executive officer of the government’s project.
“If we have to provide services to such a large number of people, we can’t do it without the private sector,” Bhushan said.
“We don’t have that kind of health care capacity in the government sector,” he said, adding he was hopeful the program would be ready by India’s Independence Day on Aug. 15.
It’s the government’s second major welfare push this year — in March it presented a draft bill on a social security program designed to cover the country’s 500 million poorest workers, including those in informal employment.
The total cost of the program hasn’t yet been calculated, but the promise is to provide poor families up to $7,250 in annual coverage. An earlier federal health insurance scheme had managed to cover just 61 percent of those eligible after 10 years of operation, government data show.
“It will not be possible for health care providers to respond to such a huge expansion of coverage without substantial investment in medical facilities and manpower,” said Owen O’Donnell, associate professor at the Rotterdam-based Erasmus School of Economics. “Without that, the extension of coverage risks being nominal rather than real.”
India has long under invested in health, and spending as percentage of GDP is lower than most low income countries, including neighbors Nepal and Maldives.
Since December, Modi’s been facing rising political turbulence.
He won his home state of Gujarat on a wafer-thin majority, lost crucial by-elections in the country’s most populous state, failed to form the government in Karnataka and witnessed protests by students, farmers and underprivileged communities.
“The Modi government has decided to launch the ambitious Ayushman Bharat health insurance scheme with an eye on the 2019 polls,” said Satish Misra, senior fellow at the Observer Research Foundation in New Delhi.