SITAPUR: While Prime Minister Narendra Modi’s nationalist tub-thumping hasbeen widely credited with his recent election win, another factor was onehe kept relatively quiet about: Modicare.
Despite some teething problems and a dire need for further reforms and morespending, this huge initiative launched last year — one of the world’slargest publicly funded healthcare programmes — has made a difference.
“This scheme has infused a sense of belief in the poor that if they fallsick they will get treatment without spending a rupee,” said Anil Agarwal,chief medical superintendent at a hospital in Sitapur, a city with some ofIndia’s worst health indicators.
Indeed, voting data from the mammoth election that ended last week with alandslide for Modi showed particularly strong support for his right-wingparty in poorer areas where people would have benefited most.
“It has certainly been welcomed as a welfare measure by the poor andprobably contributed to (Modi’s) electoral victory,” said K. Srinath Reddy,president of the non-profit Public Health Foundation of India.
The flagship programme, dubbed Modicare, covers hospital costs up to $7,200for the poorest 40 percent of Indians, or some 500 million people, in acountry where the average annual income is about $1,670.
Even before Modicare, or the National Health Protection Scheme (NHPS), wasintroduced in September, treatment was largely free at government hospitals.
But patients still had to shell out for diagnostics and medicines, whichmake up a big chunk of the costs of hospital care, as well as for implantslike stents.
Private clinics were out of reach for many, with a consultation alonecosting some 1,000 rupees ($15) — a large amount for millions living onless than $2 a day. But now poorer Indians can visit these clinics,providing they sign up to the scheme.
– New belief –
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Sabir Ali, an impoverished weaver who got a Modicare card for himself andhis family to use at any of the 15,000-odd participating hospitals, had acyst removed from his forehead.
“It was unbelievable to hold the card in my hands,” Ali told AFP, his headbandaged at the Sitapur district hospital in northern India.
“I used the card and I didn’t have to spend a single rupee on my treatment.”
Until recently only a quarter of India’s population had any healthinsurance, forcing hundreds of millions to pay out of their own pockets, goto quack doctors or just skip treatment.
An estimated 60 million Indians are pushed below the poverty thresholdevery year paying for medical care, while a report last year by The Lancetmedical journal found substandard healthcare was responsible for some 1.6million deaths a year.
Almost two million people have benefited from the scheme so far, with thegovernment allocating some $1.2 billion since the launch. The costs areshared between federal and state governments 60:40.
“Schemes such as Modicare played a larger role (in the election outcome)than anyone had anticipated,” said political analyst Parsa Venkateshwar Rao.
“The overall message that has gone out is that Modi is willing to help thepoor.”
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– Teething troubles –
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In his second term, however, Modi will have to iron out some of thescheme’s teething problems, with some hospitals complaining they cannotrecoup what they spend.
“We can’t cope with (receiving) 9,000 rupees ($128) for a caesarean sectionwhich would include stay of the patient, fees of the anaesthetist,paediatrician, medicines and so on,” said Doctor V.K. Monga from the IndianMedical Association.
“But corrective steps are being taken… The health sector is overallsatisfied now with the scheme,” he told AFP.
Reddy of the Public Health Foundation of India also said the scheme neededmore financial resources.
“If the state governments too can be stimulated to increase their healthbudgets, the scheme will become sustainable.”
More broadly, Modi needs to build more facilities, train more staff andimplement more reforms in what remains a dysfunctional healthcare system,experts say.
The newly re-elected prime minister has promised to hike health spending to2.5 percent of GDP by 2025, from 1.15 percent now — one of the lowest inthe world — but it is unclear if this will suffice.
Critics also say that Modicare helps unscrupulous private providers —already accused of over-diagnosing and carrying out unnecessary surgeries —boost profits.
Ali too has his complaints.
“I live nearby the hospital so I can come, but if someone lives outside thecity, they will struggle with the number of times they are expected tovisit the hospital,” he said.
“They make us run around a lot.”
But the family of Vindeshwari Devi, who has had her uterus removed at thesame Sitapur hospital, is satisfied.
“I think this scheme is good and it will only get better,” said SunilKumar, a daily-wage labourer and Devi’s son-in-law.
“For those who have nothing, it means a lot.” -APP/AFP
