The Big Story

Since February, it has been clear that the Narendra Modi government’s flagship project this year is going to be its national health programme. The scheme featured as Modi’s prominent policy announcement in his Independence Day Speech but with a new name – the Pradhan Mantri Jan Aarogya Abhiyan.

The scheme was expected to be launched on August 15 but this has been pushed back with the prime Minister announcing that it will now be rolled out on September 25, which is Deen Dayal Upadhyay’s birth anniversary.

Nothing else has changed.

As Arun Jaitley announced in the budget in February, the scheme – he then called it the National Health Protection Scheme – is supposed to provide health insurance cover worth Rs 5 lakh per year to 10 crore families, which is roughly 50 crore beneficiaries. These families are the poorest 40% in the country as determined by the social and economic caste census. In fact, Jaitley had announced a similar scheme in his 2016 budget but with a cover of only Rs 1 lakh. That scheme was never implemented.

The National Health Protection Scheme has also been called the National Health Protection Mission under the larger Ayushman Bharat programme.

While health insurance cover of Rs 5 lakh is much more than the Rs 30,000 per family per year that the existing Rashtriya Swasthya Bima Yojana provided, raising it is not without problems of its own. For one, the money that the government is pouring into an insurance scheme may be much better spent on improving public health infrastructure and services. Moreover, the government is pushing for private sector participation in the scheme, which health analysts fear will come at the cost of the already flailing public health system.

As many as 23 states have, however, bypassed the option of partnering with insurance companies and have instead decided to create non-profit trusts to implement the scheme. In Odisha, Naveen Patnaik stole a march on Modi on Independence Day by launching a state health insurance scheme called Biju Swasthya Kalyan Yojana that also offers Rs 5 lakh per family per annum and promises to cover 70 lakh families or 70% of the state’s population. Odisha has refused to join the centre’s health protection scheme.

The other component of Ayushman Bharat is upgrading health sub-centres across India into better functioning health and wellness centres. This is supposed to bolster the primary healthcare system and provide preventive healthcare so that fewer people fall sick and need to go to hospital. But the health and wellness centres have received little attention even while the government has been talking up the insurance scheme. Even budget allocations do not seem to back the promise of health and wellness centres across the country.

With the new name, Modi has certainly kept the conversation about his government’s ambitious health protection plan going. But one has to wonder if the prime minister, with his fondness for acronyms, has thought this one through. Does he really want to be going into an election with people saying PMJAA?

The Big Scroll

Shamika Ravi, member of the Prime Minister’s Economic Advisory Council, says that insurance should not be the only health financing model for India.

The National Health Protection Mission provides cover for hospitalisation but does not address the biggest cost to patients – buying medicines.

Punditry

In Indian Express, Jaideep Malhotra says India’s abortion laws have to be amended to take into account agency of women. Narendra Modi’s Independence Day speech mirrored both his offer of the fantasy of hope and refusal to acknowledge the republic of fear, says Pratap Bhanu Mehta in the same paper. Prashant Reddy T in The Hindu argues that the case for restricting the manufacture of oxytocin, a emergency drug, is neither rigorous nor reasoned. Modi’s Red Fort speech did not have enough clarity on economic reform ideas for the coming years. His more resonant message was on social inclusion, says this Mint editorial.

Giggles

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