Modicare: How govt plans to use 'Ayushman Bharat' to transform health care

Under Ayushman Bharat, often called Modicare, the plan is to offer universal health coverage to 500 mn beneficiaries from 100 mn vulnerable families, with each family getting Rs 500,000 as cover

Healthcare facilities in India bring to mind the scenes of chaotic meandering waiting lines, inadequate resources and tragedies endured with stoicism. A helpless lot of people are seen willing to sell every living possession in the hope of curing their beloved and ailing. Government-run public hospitals are a story of inadequate resources. The numbers, however, seem to be getting better. The private corporate sector has added approximately 60,000 beds to the superspeciality and tertiary care segments. 

Perhaps keeping in mind that health-related expenses are the single most debilitating issue that can drive the already poor segment into abject penury, Finance Minister Arun Jaitley in Budget 2018-19 announced the Ayushman Bharat scheme for a healthy India. The plan is to offer universal health coverage to about 500 million beneficiaries (100 million vulnerable families). Every family will get up to Rs 500,000 as cover for medical treatments. Insurance would be extended through the universal health coverage of the National Health Protection Scheme (NHPS). This scheme is targeted at secondary and tertiary care hospitalisation in both public and private hospitals that are empanelled. 

The government has announced the setting up of 150,000 health and wellness centres for primary care and women's health, and to distribute essential drugs and basic diagnostic services. The government has allocated Rs 12 billion, and the healthcare delivery industry has been suggesting a partnership model where some of the services can be deployed through application-based remote-monitoring technologies.

Some centres can be adopted by the private sector with expert manpower and a visiting doctor at a designated time. 

Ayushman Bharat comes under the National Health protection mission, where states would partner with the Centre through state nodal agencies.

Here are some of the salient features of the Ayushman Bharat scheme vis-à-vis the recommendations of the health care industry: