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India’s Ambitious Health Care Plan Sparks Hope, Questions

“I am scared about how I will repay the money I have borrowed. What can a man working on daily wages do? It is in God’s hands,”

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Shavan Kumar has travelled to New Delhi with his wife from his village to get her treated for a heart condition at a government hospital, where treatment is free. VOA

From a small village in Uttar Pradesh, laborer Shavan Kumar has brought his 38-year-old wife to a government-run hospital New Delhi to be treated for a heart condition. But he worries that the $500 loan he has taken will not cover the cost of her medical care; although the treatment is free, he has to pay for medicines, tests and their stay in the city.

“I am scared about how I will repay the money I have borrowed. What can a man working on daily wages do? It is in God’s hands,” Kumar said.

The Indian government has announced it will implement what it calls the world’s largest public health insurance plan, offering coverages of about $8,000 to poor and low-income families. That could be a game-changer for the 63 million people like Shavan Kumar who are driven into poverty every year by “catastrophic” expenses on health care, according to the Health Ministry.

ALSO READ: How govt can provide better healthcare system to more than 125 crore people in India

Dubbed ‘Modicare’ in a reference of Prime Minister Narendra Modi, the hugely ambitious scale of the project – which proposes to ensure 500 million people – has caused a wave of optimism in a country where improving access to health services has never been a political priority.

However, in a nation where many government initiatives are hobbled with poor implementation, there are concerns about how it will work and how it will be funded.

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Quality public hospitals such as the All India Institute of Medical Sciences in New Delhi where Shavan Kumar brought his wife, are few in number, confined to the big cities and hugely overburdened. VOA

Priya Balasubramaniam, a health specialist at the Public Health Foundation in New Delhi questions whether the $300 million earmarked this year will get the project off the ground. “While this has definitely come with a bang, I think for those of us who want to move to the next level, it is really about the fiscal space that the government has allocated for a scheme as ambitious as this,” she says.

ALSO READ: “Dual-Disease Burden”? India’s Great Healthcare Challenge and Opportunity

Officials say the vast scale of the project will drive down insurance premiums to as little as $18 per year. That adds up to $1.7 billion – an outlay that the government plans to make with funds pooled by both the federal and state governments.

Closing rich and poor gap

Health experts also hope the insurance cover will improve the quality of care by opening the doors of India’s expensive private hospitals to the poor.

A massive gap exists between private and public hospitals. The former have state-of-the-art medical facilities but only the upper-income groups can afford their steep costs. On the other hand, quality public hospitals such as the All India Institute of Medical Sciences where Shavan Kumar brought his wife offer free treatment, but are few in number, confined to the big cities and hugely overburdened.

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Private hospitals in India offer state-of-the-art facilities but only people in upper-income groups can afford them. VOA

That is the dilemma that Hari Singh, a New Delhi resident, faced when he broke his knee in a road accident three months ago. Having no savings, he first went to a government hospital, but left quickly and headed to a private hospital.

“The conditions were so miserable, the toilets were filthy, two patients were put on one stretcher and there was no system at all. I got very scared,” he says.

ALSO READ: Diseased, Ignored and Suffering Silently: A look into the Health Status of Adivasi Women in Jharkhand

But to pay for his care he had to borrow $5,000 at a crippling interest rate of 5 percent a month. Now he does not know when he can return to his job as a driver or how to support his two young children.

Ashok Agarwal, founder of the Indian Institute of Health Management Research, hopes the new government project will change that. “For the first time poor people would have a choice to go to a center where they feel comfortable,” he says. “Once you have insurance which is willing to pay, then the load of the patients can go to the private sector also.”

He says it will also incentivize private hospitals to improve facilities to attract patients. “Imagine you can have 500 million customers at your doorstep. Which company would not like that to happen?”

Health professionals underline that the insurance initiative needs to go hand-in-hand with improved primary health services and point out that poor people often land up in hospitals because they cannot afford day-to-day medical care and medicines.

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The burden of disease rises among poor people because they cannot afford to buy needed medicines. VOA

But most government-run medical centers “are dysfunctional, lacking equipment, medicines and even qualified staff,” says Balasubramaniam, the health specialist at the Public Health Foundation in New Delhi. “You are focusing on the top of the pyramid while the foundations are still very shaky.” For example, Shavan Kumar may never have needed to head to a hospital in New Delhi if his wife’s condition had been diagnosed earlier.

But in a country where government spending on health care is among the lowest in the world – just 1 percent of the GDP – the project has sparked hope. “What the government has done in one stroke is to look at 500 million at the same time. I have no doubt it will take a few years to come on the ground and be stabilized, but the intent is very good,” says Agarwal. (VOA)

Next Story

Know How Grammy Award Winner Inspired by PM Modi to Dedicate Music to Environment

From songs like "Ganga" - depicting the plight of the river considered holy by most Indians - to his Grammy-winning album "Winds of Samara" - which speaks of peace and global harmony

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"What was to be a photo opportunity with the Prime Minister turned into an hour-long discussion with him on environment. He spoke on the impact music could have on society and inspired me to make music on environment," Kej told IANS in an interview here. Wikimedia

A chance meeting with Prime Minister Narendra Modi in September 2015 in New Delhi inspired Bengaluru-based Grammy Award winner Ricky Kej to dedicate his life and music to the cause of environment.

Since then, Kej, who has represented India on global fora, performing at venues including the United Nations General Assembly in New York and UN Headquarters in Geneva, has been using music to flag ecological issues to policymakers and public the world over.

“What was to be a photo opportunity with the Prime Minister turned into an hour-long discussion with him on environment. He spoke on the impact music could have on society and inspired me to make music on environment,” Kej told IANS in an interview here.

From songs like “Ganga” – depicting the plight of the river considered holy by most Indians – to his Grammy-winning album “Winds of Samara” – which speaks of peace and global harmony – Kej’s music connects with all — from world leaders to the man on the street.

With the aid of compelling visuals, Kej’s music, and collaborations with global music artists, highlights the deleterious consequences of urbanisation, climate change and human-animal conflict.

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From songs like “Ganga” – depicting the plight of the river considered holy by most Indians – to his Grammy-winning album “Winds of Samara” – which speaks of peace and global harmony – Kej’s music connects with all — from world leaders to the man on the street. Wikimedia

“There are so many issues in India like child labour, gender inequality and poverty, which none seem to be reflecting through music. We see that music has lost the identity of being an art form and has become a profession,” he lamented.

Kej, 37, bagged Grammy in 2015 for the ‘Best New Age Album’ for “Winds of Samsara”, created along with South African flautist Wouter Kellerman. He is also recognised as the ‘United Nations Global Humanitarian Artist’ for his music with environmental consciousness.

The subjects of Kej’s music include, the rising air pollution in global cities and towns, the perils being posed to wildlife due to urbanisation and the story of Republic of Kiribati, an island nation in the central Pacific Ocean off Fiji, whose coasts are receding each year due to rising ocean levels due to global warming, among others.

With 15 studio albums released internationally, 3,500 commercials, three feature films in Kannada and over 100 music awards in 20 countries to his credit, the conservationist-musician’s album “Shanti Samsara” was released by Modi and then French President Francois Hollande at the United Nations Conference of Parties (CoP-21) Climate Change Conference in Paris, held from November 30-December 12, 2015.

The album, conceived after his meeting with Modi, had Kej collaborate with about 500 musicians from 40 countries, for songs like “Ganga”, throwing light on the pollution plaguing the river, and on “Earth and Water”.

“Politicians and policymakers are used to statistics and numbers, but when one approaches them through art, it makes a lot of difference. I have seen politicians change their perspectives towards environmental causes after attending my concerts,” Kej asserted.

The element of environment and nature in his work comes from his own experiences. For instance, he composed the song “One With Earth” – which highlights natural farming and the need to give up chemical fertilisers – after he lived with the tribals in Andhra Pradesh’s Araku Valley to understand their lifestyle and traditional farming techniques.

Grammy award winner, modi
“There are so many issues in India like child labour, gender inequality and poverty, which none seem to be reflecting through music. We see that music has lost the identity of being an art form and has become a profession,” he lamented. Wikimedia

Born in 1981 in North Carolina in the US, Kej moved to Bengaluru with family when he was eight, with intense love for music and nature.

“As a child, I felt music and nature were connected and found music in the sounds of nature, birds and animals. I used to look at music as a way of understanding history, cultures and emotions from different parts of the world. A lot of my education was through music,” said Kej, who was part of a rock band “Angel Dust” during his class 12th from Bishop Cotton Boys’ School in Bengaluru.

Even as Kej pursued a dental science course on his father’s advice, he continued to create music and decided to pursue it full-time on completing the degree.

“Like most musicians, I started my career with popular music and later turned to heavy metal and jazz. I finally zeroed in on world music as it connects with the people the world over, irrespective of the language they speak,” Kej recalled.

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As a professor at the National Institute of Advanced Studies (NIAS) in the renowned Indian Institute of Science (IISc) campus in this tech hub, the musician believes his job is to approach environmental subjects artistically.

“Numbers don’t hit people as hard as visuals and art can. My job as a musician is to drive the numbers and data through emotions,” Kej added. (IANS)