Before starting national coverage, fix primary health care first

The number of doctors for every 1,000 Indians is 0.76, which is one of the lowest such ratios in the world

When Finance Minister Arun Jaitley delivered the Union Budget for 2018-19 last week, he included a promise to roll out a major government subsidised health insurance scheme that covered catastrophic medical charges up to Rs 500,000 for 500 million Indians. Many questions have been asked about the design and funding of this proposed scheme. Yet the secondary and tertiary care this scheme will likely fund is only a part of the problem. Primary health care — the first contact between a patient and the health care system, usually within their own community — is indeed perhaps even more important. The