Yes I was poor at Maths
After my 10th Std board exam I got a tight slap from my maths teacher for having answered one sum wrong which reduced my marks from 100 % to about 97 % hence I decided to follow medical stream to avoid any further slaps thereafter. But even my weak maths is boggled by the figures I kept going over and over again in my mind since yesterday’s dramatic announcement of the Greatest Government Funded Health Scheme in the World. 10 Crore Families to be covered for 5 lacs health insurance; wow !
Last I negotiated on behalf of MLAG, a 5 lac family health cover even for a group of doctors is on negotiated rates available at about 15000-22000 Rs annual premium. Assuming the Government arm twists the public sector Insurance companies to give premium rates as low as 2500 per family it still works out to a mind boggling 25000 crores. Total healthcare budget increase is about 11 percent or less than 5000 crore over the planned budget outlay for 2017-18.Actually there is only a 5% increase (Rs 2500 cr) over the revised estimate for 2017-2018. Out of this marginal increase 1200 crore is for wellness centers, 24 medical colleges are to be set up for an unknown amount and 600 crore is for TB patients. Where is this extra 25000 crore going to come from ?
Experience with previous Government sponsored health insurance schemes has been that they are the genesis of corruption in healthcare. Insurers claim that Group Healthcare policies push them into losses. Still we follow the insurance model because our geniuses at Planning... sorry Niti Ayog think it is cheaper for Government to be populist in this way. Sir the costs of actual treatment remain the same whether Patient, Government, Insurance Company or Niti Ayog pays. If it was possible to provide universal healthcare so cheaply and so easily we would be having reverse migration from US, Europe and Australia to India. Even Pakistan would be wanting to reverse the partition of 1947 and again become a part of India.
Even the much acclaimed Health & wellness centers are a new name for subsidiary Health Centers which do not have any doctor MBBS or otherwise posted in them. The generous 1200 crore will be divided in these 1.5 lac centers with Rs 80000 allocated per year for each center. Maybe this amount will be sufficient to paint the new name and slogans on walls of these subsidiary Health centers rechristened as Health & Wellness centers.
I thought budget was a serious document which was the road map of anything fiscal and showed the path chosen by the Government of the day for the nation. Not that previous Governments have not used it for political grandstanding but in this is akin to be-fooling people. What is going to happen is that the failure of the expectation of 50 crore population of the country to get free healthcare will be laid at the door of doctors while the corporates both in healthcare and Insurance sectors laugh their way to the bank. Before the race among hospitals to get empanelled for "Modicare" hots up I wish a thorough analysis of the scheme and its repercussions are understood with clarity.
Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
Director Hope Gastrointestinal Diagnostic Clinic,
Sco 1066-67 Sector 123 New Sunny Enclave Mohali
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