The Indian government’s launch of what it claims will be the world’s largest publicly funded health insurance scheme has prompted scepticism and criticism from medical representatives.
The programme—officially called Ayushman Bharat-National Health Protection Mission (AB-NHPM) and popularly known as “Modicare”—aims to provide publicly funded health insurance cover worth 500 000 rupees (£5445; €6220; $7675) per family per year, for 100 million poor families or 500 million people in India.
Ministers have hailed it as a major step towards universal healthcare in India.But the Indian Medical Association criticised the announcement as “improperly planned” and “ill-conceived,” citing a lack of consultation with doctors and patients over the plans.
The scheme was approved by the union cabinet on 21 March and is likely to be launched by the end of July this year. It has received a fund allocation of 100 billion rupees for 2018-19 and 2019-20.
The Indian government’s press information bureau said that the programme is poised to be the world’s largest publicly funded health insurance scheme. Beneficiaries of the scheme will get cashless insurance cover for treatment of diseases in public hospitals and eligible private hospitals throughout India.
India’s health minister, Jagat Prakash Nadda, said in a statement, “All public hospitals in the states implementing Ayushman Bharat-NHPM will be deemed empanelled for the scheme. As for private hospitals, they will be empanelled online based on defined criteria.”
The minister said that all pre-existing health conditions of beneficiaries will be covered under the scheme from day one of the policy, adding that they will have a specified transport allowance for every admission. The payment of the policy’s premium will be shared between the state and the central governments.
However, speaking to The BMJ, Ravi Wankhedkar, president of the Indian Medical Association, said, “It is an improperly planned, ill conceived, mere populist announcement. [In this scheme] the choice of physician and choice of hospital was not given to patients.”
He added that “vibrant private sector, mainly small and medium-sized doctor-owned hospitals, which significantly contribute to primary and secondary healthcare, will be left out.” He also noted that, in setting up the scheme, “all stakeholders were not actively consulted.”
Wankhedkar said that the actual budget spent will not match the allocations for the scheme, adding that “Modicare will go the way of Obamacare.”
Shantanu Panja, consultant ENT surgeon at the Kolkata based Apollo Gleneagles Hospitals, told The BMJ, “India, because of its diverse fabric, poses challenges in implementation of such a project owing to political animosity between centre and state at times. Moreover, regulation at every level is needed so that it is not misused.”