India Today – October 08, 2018

4 INDIA TODAY OCTOBER 8, 2018

BIG MERGER,

SMALL GAINS

PG

AADHAAR TO STAY,

WITH RIDERS

PG 8

INSIDE THE TRUMP

WHITE HOUSE

PG 12

THE CRIMINALS

WE ELECT

PG UPFRONT

O

n Sunday, September 23, Prime

Minister Narendra Modi laun-

ched the Pradhan Mantri Jan

Arogya Yojana (PMJAY) insurance

scheme aka ‘Modicare’. It was billed,

with his characteristic grandiloquence,

as the ‘world’s largest healthcare pro-

gramme’, a reform that will be ‘visible

from space’. Fact is the government’s

National (Rural) Health Mission,

launched in 2013, covers a much larger

population than the 107 million fami-

lies or 500 million supposed beneficia-

ries of the PMJAY.

For more than a decade, schemes

like the Rashtriya Swasthya Bima

Yojana at the national level, and state

schemes in Andhra Pradesh, Tamil

Nadu, Maharashtra, Rajasthan and

Karnataka, have been implemented

with annual covers ranging from

Rs 30,000 to Rs 3 lakh per family. The

PMJAY is designed on similar lines.

It is necessary to look at the evidence

from these schemes, which the govern-

ment seems to have ignored.

These schemes are meant to protect

people from incurring large expenses

on hospitalisation. Studies of previous

schemes show that patients have to pay

from their pockets even though hospi-

tals are supposed to provide free servic-

es. According to the 71st round National

Sample Survey, an insured patient

going to a private hospital still ended

up paying an average of Rs 18,000 from

her pocket. Private hospitals have been

found providing unnecessary and selec-

tive profitable services.

So, while their benefits are un-

certain, what are the costs of these

schemes? The experience of states like

Kerala, Rajasthan and Chhattisgarh

is that claims keep rising under these

schemes, premiums shoot up and the

government ends up paying. In Chhat-

tisgarh, for instance, the premium has

increased from about Rs 300 to Rs

1,100 in six years. The state will need to

spend Rs 600 crore this year on insur-

ance for a cover of just Rs 50,000.

Claims money, it has been found,

goes mainly to private hospitals:

scheme data shows private hospitals

MODICARE

By Sulakshana Nandi

MORE BUSINESS, LESS CARE

THE LAUNCH
The PM issues health
cards in Ranchi
on Sept. 23, 2018

PARWAZ KHAN/GET T Y IMAGES)

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