Modicare – a large step in the right direction, but there’s a long road to travel

“Modicare” – has launched. But the scope of its ambition has yet to be matched by investment or uptake.

Questions have been asked in some quarters as to whether this is a genuine attempt to solve the plight of the poorest, or a cynical play for votes from a party in the home straight of an election run.

It’s hard to fault the ambition. The health insurance scheme aims to give India’s most in need (the poorest 40%) a $7k safety net – but the service can only stretch as far financially as it is funded and as wide geographically as participating hospitals are spread and users are signed up.

Early indications are not promising. Looking at financing, the insurance scheme’s first-year budget is 0.01% of the country’s GDP. That’s just $300m, which raises questions of priority when you consider that, by comparison, India’s 2016 defence spending was almost $64bn, or 2.5% of GDP.

As for hospital uptake, the vast majority of hospitals enrolled in the scheme are government-run. Despite positive noises the likes of Aster DM and Apollo have yet to enrol in a system which will pay 20-25% less than current government tariffs with, our sources tell us regularly, no certainty of quick payment.

Perhaps most surprisingly, patient uptake is low though not, we suspect, due to lack of interest. There have been substantial logistical difficulties handing out so-called gold cards to those in need. As we report elsewhere, populous Bihar, for example, was reported to just 1,592 gold cards from a population of 99m.

It’s far too soon to say Modicare – Ayushman Bharat to give it its proper name – will not work.

But to work it needs more money, and more hospitals to sign up.

It’s not too soon to say, even if it is ultimately successful – as we all wish it to be – this will be no quick fix.

We would welcome your thoughts on this story. Email your views to David Farbrother or call 0207 183 3779.