Mechanics of Modicare: The health scheme fine print

作者:Aimee    發表日期:2018-09-27 18:11:19

The government is calling it the "world's largest government healthcare scheme"--- the showpiece announcement of the Budget 2018 was a healthcare assurance scheme.

The target will be 10 crore poor families and they will get health insurance coverage of up to Rs 5 lakh per year. But, the Budget set aside only Rs 2,000 crore and this drew flak from the opposition.

The government explained that Niti Aayog will get into a deliberations with the state government to thrash out the fine print and the think tank estimates that this scheme could cost Rs 10,000 crore.

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The government is working with an estimate that the cost for every family will be Rs 1,200 in terms of premium. However, according to a CLSA report, they estimate that for this scheme to take off, the Centre needs to shell out Rs 2,500 per family and that puts the cost of the entire scheme at over Rs 24,000 crore.

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So who will foot the bill? The Centre hopes that it will pay up to 60 percent of the total costs and the states can spend the remaining 40 percent. The government believes that several states can subsume their current health schemes and this scheme will then become more cost-efficient.

One state model that government is closely looking at is Rajasthan --- the state's health scheme covers those below the poverty line and provides coverage of up to Rs 3.5 lakh.

But, there has been controversy over the benefits of this scheme and the fact that it is not reaching everyone. The Rajasthan model uses 2 levels of identification --- one is a separate insurance card and the others is any photo ID like Aadhaar, Pan Card, Driver's License etc., but Ration Cards are not allowed and this, many believe, has led to wide-spread exclusion of the poor.

So, is this new health scheme the pill that India needs and how can the government avoid elimination of those in need. How can private hospitals and insurers be held accountable?

An eminent panel of experts like Kiran Mazumdar Shaw of Biocon, Shailaja Chandra, Former Health Secretary for Delhi Government, Monika Halan, Consulting Editor of Mint, Sandeep Patel, CEO of Cigna-TTK Health Insurance and Joydeep Roy, Partner Insurance at PWC and CNBC-TV18’s Yash Jain who was following up on this scheme discussed all this and more.

For entire discussion, watch accompanying video.