Universal healthcare is a must for Viksit Bharat
Wider health insurance coverage, as with India’s accident care plan, is welcome. But it’s a stopgap at best. We should aim for an efficient state-run healthcare system that covers all
Considering India is among the countries with the highest number of road accidents in the world, it’s welcome news that victims are on the Centre’s policy agenda for help. Too many lives are lost in such accidents. Prompt medical attention might have saved many of these lives. Those in dire need sometimes get turned away or face the danger of delayed treatment while hospitals figure out who will pick up their bills. Delays can harm even patients whose health is insured, as prior approvals for cashless procedures can take hours in a loop of claim checks. Given this backdrop, the government’s plan to facilitate cashless accident emergency care is thoughtful. On Monday, Mint reported that the ministry of road transport and highways has a scheme in the works that would provide up to ₹1.5 lakh of cashless treatment for every victim of a traffic mishap. This facility will be available to all without exception, regardless of whether they are covered by a health insurance policy or not, and will cover hospitalization for up to a week from the incident’s date at all facilities under the Ayushman Bharat plan. With payment assured, treatment refusals and delays should drop. The money so spent would be reimbursed through the Motor Vehicle Accident Fund, which was set up in January 2022 to compensate hit-and-run victims. The purpose of this fund will be enlarged accordingly.
While further details of the scheme are still awaited, its planners seem keen to keep its fiscal cost low. The extent to which medical bills can be passed onto insurers of people’s health and/ or vehicles is being explored. Talks are said to be underway with general insurers on using a part of the premium paid by vehicle owners for third-party coverage. If put in place, such a programme would save lives. In spirit, it would follow Ayushman Bharat, a scheme of subsidized health coverage aimed at greater insurance inclusion. The logic of such safety cushions draws upon the ‘law of large numbers’: As the numbers under watch go up, events in the real world get closer to a pattern that theory says is most probable. So, the more people we cover, the more reliably we can attain payout stability, plot future expense trends and sustain the insurance cushion. As road crashes offer us a pile-up of data to analyse, the latest proposal’s fiscal math can be worked out quite easily.
Expanded insurance works well for quick welfare expansion, but it’s a stop-gap arrangement at best. Ultimately, a Viksit Bharat must provide direct healthcare services via a network of reliable facilities that attend to everyone promptly, efficiently and costlessly (or cheaply). This is what sets apart the world’s happiest countries. The predictability benefit of large numbers applies to state-run health systems too. If this is leveraged well, the rigmarole of insurance could be left out of the welfare deal. A robust public health system would also restrain runaway prices charged by the private sector, whose domination, profit orientation and large bills are what make health plans so vital in India. Moreover, unequal access to quality services is a problem far better solved directly than through insurance; going cashless under the latter tends to require too many okays for people to count on, especially if precious time is ticking away. While private medical care should be free to thrive, subsidized state provisions are a must. Unless we intend to proceed along a suboptimal path as our economy expands, fiscal planning for a big upgrade of services should begin.