30 12 febraury 2018Modi Government that finds expression in the most audacious ini-
tiative of this budget—the ayushman bharat yojana (aby), billed
as ‘the world’s largest healthcare programme’. In scale, the aby is
quite staggering and will include nearly half the population of India.
Its costs will be substantially met by the 1 per cent healthcare cess on
Income Tax and will cover hospitalisation and other medical costs
of individuals upto an annual rs 5 lakh, a significant amount that
factors in market costs. although medical care can be availed of in
government hospitals—but not exclusively so—its administration
will not be vested in the hands of the state. Instead, it is likely that the
Government will pay medical insurance premia to a gigantic insur-
ance company that will be formed by the merger of three general
insurance companies in the public sector.
The details of the aby have not yet been announced, but it is
quite clear that the Prime Minister is intent on using the scheme to
build an important pillar of an Indian welfare state. If the rollout,
which also involves the upgradation of government hospitals in
district headquarters and the streamlining of the Medical Council
of India, is successful, it will become the basis of a universal health-
care system in India. a senior minister tells me that if the costs ofthe present programme can be met by the imposition of a 1 per
cent dedicated cess, there is no reason why a 2 per cent cess won’t
be able to convert the aby into a universal healthcare system.
That, however, is jumping the gun. If the aby is to produce the
type of electoral returns that Modi and bJP President amit shah
hope it will, there would have to be a dramatic expansion and up-
gradation of hospital services to cater to patients who will no lon-
ger be satisfied by the dismal facilities that are to be found in most
government hospitals, not least in district and subdivisional towns.
what the Modi Government may have successfully done
with the announcement of the aby is to put healthcare firmly
on the political agenda. There will now be intense pressure on
the political system to not merely trigger aspirations, but also
deliver a health system that is seen to be part of a caring society.
In his intervention after the budget, the Prime Minister spoke
of the need to supplement the ‘ease of doing business’ with the
‘ease of living’. Huge investments in infrastructure, particularly
the spate of road construction, will certainly be a factor in this and
directly or indirectly contribute to more economic activity and,
consequently, more livelihood opportunities. In this context, twothrust areas of the Government are significant.
first, the Ujjwala scheme to create a smokeless kitchen by of-
fering free gas connections to women below the poverty line has
been a great success. according to the economic survey, a total of
30.5 million gas connections had been released till october 31st,- what is more encouraging is that some 70 per cent of those
women provided with the initial connection have gone in for refills,
suggesting that the use of cooking gas over more traditional stoves
may gradually end up being part of the household drill. The budget
has increased the target of beneficiaries from the still-unrealised 50
to 80 million. If even 70 to 80 per cent of this target is met, it will be a
big contribution to the ‘ease of living’ of women.
secondly, the Government’s bid to secure full rural electrifica-
tion by 2019 has had encouraging results. as on april 1st, 2015,
there were 18,542 villages in India without power connections.
by November 30th, 2017, 15,183 of these villages had grid-supplied
power (and 1,052 villages were found to be uninhabited). The re-
maining 2,217 villages are expected to be connected by May 2018.
The saubhagya yojana took this universal electrification
a step further by ensuring a light and fan installation in all
poor rural households free of charge.
The budget has set aside rs 16,000 crore
for this scheme. If carried out with effi-
ciency and commitment, this initiative,
apart from yielding political dividends, is
certain to have a multiplier effect on the
entire economy.
over the past few years, but par-
ticularly after the bJP’s 2015 defeats in
bihar and delhi, Modi has been trying to
change the social character of the party
in a gradual and non-demonstrative
way. The social centre of gravity of the
bJP was always the lower middle-classes,
with traders exercising a disproportionate influence. since he
assumed charge as Prime Minister, Modi has been working
relentlessly to push the centre of gravity further down the eco-
nomic ladder. In particular, an exceptional amount of attention
has been paid to the creation of a political constituency of the
poor—an approach that fetched returns in Uttar Pradesh. Hav-
ing initiated deep structural reforms in the more ‘modern’ sec-
tors of the economy and having ensured that corruption and
leakages from government schemes have fallen dramatically
through the use of technology, Modi has used the 2018 Union
budget to create the architecture of an India where India and
bharat can begin to complement each other.
The task is daunting and its foremost challenge is the impatience
of an electorate for instant returns. Politically, in the coming year,
he has to convince people that India is on the right
track under his leadership and that there will truly
be achche din if they can hold their nerve. n
Swapan Dasgupta is India’s foremost conservative
writer and an open contributor. He is a Rajya Sabha MPWhat the Modi Government may have (^)
successfully done with the announcement of the
Ayushman Bharat Yojana is to put healthcare firmly
on the political agenda. There will now be intense pressure on
the political system to not merely trigger aspirations, but also
deliver a health system that is seen to be part of a caring society
budget 2018
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