All the poor people identified by the Socio Economic and Caste Census 2011 will be eligible for the scheme, officials said, adding that it will be linked to Aadhar but will not be a mandatory condition for availing the benefit.
The mega healthcare plan announced in the Budget to provide 10-crore poor families with insurance cover against hospitalisation will cost up to Rs 12,000 crore annually and is likely to be launched on August 15 or October 2, officials said on Friday.
The 'National Health Protection Scheme', dubbed as 'Modicare' and the world's largest government healthcare programme, will be funded with 60 per cent contribution coming from the Central government and the remaining from the states, said NITI Aayog advisor Alok Kumar.
Premium for availing health insurance cover of up to Rs 5 lakh is expected to be around Rs 1,000-1,200 annually for every household, which will be borne by the Centre and the states, he said.
In his Budget for 2018-19, Finance Minister Arun Jaitley had provided an initial corpus of Rs 2,000 crore for the National Health Protection Scheme (NHPC) that aims to provide medical cover of up to Rs 5 lakh to over 10 crore poor and vulnerable families, constituting 40 per cent of India’s total population.
On Friday, Jaitley promised more funds depending on the rollout requirement.
According to Vinod Kumar Paul, Niti Aayog member and architect of the scheme, the 1 per cent additional education and health cess would be sufficient to meet the cost of the scheme.
All the poor people identified by the Socio Economic and Caste Census 2011 will be eligible for the scheme, Kumar said, adding that it will be linked to Aadhar but will not be a mandatory condition for availing the benefit.
The scheme, the finance minister said, will be cashless and not a reimbursement scheme and promised more funds if required depending on the rollout later next financial year.
“It takes care of hospitalisation, the secondary and tertiary care. Obviously, it will involve various state hospitals and select private hospitals. It can be on trust model, it can be on insurance model. It's not on reimbursement model because too many complaints come on the reimbursement model,” the minister said in New Delhi.
The model is now being worked out by the NITI Aayog and the Health Ministry, Jaitley said, adding the date of implementation would be next financial year beginning April 1 and sometime in the course of the year, it will be worked out.
If assuming the model to be insurance led, the premium shrinks with the increase in number of policy holders, he said at the event organised by Open magazine.
Economic Affairs Secretary S C Garg said, “The government will make the scheme very simple. One of the criticisms of RSBY (Rashtriya Swasthya Bima Yojna) was that everybody was required to register and registration process was very complex. This would be a very simple approach.
“It would be like flagship insurance scheme like PMJJY (Pradhan Mantri Jeevan Jyoti Bima Yojana) or PMSBY (Pradhan Mantri Suraksha Bima Yojana) which is linked to the account.”
Separately, Rashtriya Swayamsevak Sangh-affiliated Swadeshi Jagran Manch cautioned the government against engaging foreign insurance companies for providing health cover to the poor.
SJM co-convenor Ashwani Mahajan in a statement said ‘foreign insurance companies should not be engaged so that valuable resources of the country are retained in India only’.
“There will be no resource crunch for the scheme as Rs 2,000 crore earmarked as RBSY/NHPS as initial allocation and RSBY will be subsumed in NHPS," Paul said.
He further said the states will be given the choice to either opt for insurance based model or Trust based model for implementing the scheme.
While the Centre will bear an annual burden of around Rs 5,000-6,000 crore towards premium on health cover, the remaining amount will come from the state governments, he said.
In the first year, the burden on the Centre is likely to be around Rs 3,000 crore.
Niti Aayog CEO Amitabh Kant said the challenge is not resources for the scheme but challenge is its implementation.
On Thursday, Jaitley in the Budget speech had said, "We are all aware that lakhs of families in our country have to borrow or sell assets to receive indoor treatment in hospitals. The government is seriously concerned about such impoverishment of poor and vulnerable families. Present RSBY provides annual coverage of only Rs 30,000 to poor families."
Several state governments have also implemented supplemented health protection schemes providing varying coverage, he had said in the Lok Sabha.
The finance minister advocated that the central and the state government can pool in resources for healthcare to achieve efficiency.
He also emphasised on having better hospitals in rural areas even though Tier I and Tier II cities have good hospitals.
Setting up of hospitals in various districts is the state subject under the federal structure, he added.
Paul said the government will also open 1.5 lakh health and wellness centres which will provide free drugs and free diagnosis facilities.
“The building of health and wellness centres will be the best building in the village and it will also provide yoga and physiotherapy facilities,” he said.
Kumar said around 6-7 crore persons fall into poverty each year due to medical expenses and they are often in non poor category.
‘Finances will never be a problem’
Seeking to allay concerns about the funding of the scheme, Union Health Minister J P Nadda said finances would never be a problem and the Centre was working out the nitty gritties of the programme.
It's a 'revolutionary and courageous' budget wherein 'bold' decisions have been taken. It's a friendly budget for all sections of society, he said.
'Namocare' deals with primary, secondary and tertiary healthcare 'comprehensively', and the government is committed to rolling it out, the minister said.
"We will give the details but not today. We are working on the nitty-gritties. We have to work that out with all other departments as well," Nadda told reporters when asked how the government would go about implementing 'Namocare'.
Every aspect of the scheme 'has been calculated... We have made all arrangements for it'.
The details will be shared only when the government is ready to launch it, he said.
"It's not only an insurance. There are many models which we are going to work out. We will come up with a full programme. We are going fast on it," he said.
The scheme will also bring a change in the socio-economic scenario. It will increase the productivity of the common man, he said.
Nadda said the government will pay for the 'premium for the NHPS with state's share. Rs 2,000 crore has been kept for it as of now'.
"History is witness that whatever we (the BJP-led government) have committed to, we have completed. That's why finance is not a problem, has never been a problem and will never remain a problem," he said.
Photograph: Rupak De Chowdhuri/Reuters