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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)

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Now India is One of The Most Open Countries for FDI: Narendra Modi

Modi had conceptualised the summit as Gujarat Chief Minister in 2003 to position the state as an ideal investment destination after the 2002 riots.

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Prime Minister Narendra Modi on Friday said that his government had made doing business in India easier, cheaper, faster and smarter with his term accounting for almost 45 per cent of the Foreign Direct Investment (FDI) that the country received in the last 18 years.

Speaking at the inaugural function of the Vibrant Gujarat Global Summit 2019 here, he said India was now one of the most open countries for FDI with over 90 per cent approvals put on the automatic route.

“In the last four years, we have received FDI worth $263 billion. This is 45 per cent of the FDI received in last 18 years,” Modi told the gathering.

He said India was among the top 10 FDI destinations.

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PM Speaks on FDI www.news.civilserviceindia.com

Modi, who is on a three-day visit to his home state to throw open his pet biennial Vibrant Gujarat Global Summit, said the India of today was a land of “immense opportunities” being the only place that offered democracy, demography and demand.

“Fifty cities in India are ready to build metro rail systems. We have to build 50 million houses. The requirement of road, rail and waterways is enormous. We want world class technologies to achieve our goal in a faster and cleaner way. India is thus, a land of immense opportunities.” he said.

The Prime Minister said the challenge for India, as in most emerging economies, was to grow horizontally as well as vertically to ensure that the benefits of development spread to regions and communities that have lagged behind while also meeting enhanced expectations in terms of quality of life, quality of services and quality of infrastructure.

“We are well aware that our achievements, here in India, will directly impact one sixth of humanity.”

Modi said his government had removed the barriers which were preventing India from achieving its full potential and now it was ready for business like never before.

The government has made doing business easier. cheaper, faster and smarter, he said.

“In the last four years, we have jumped 65 places in the global ranking of World Bank’s Doing Business Report. From 142 in 2014 to 77 now, but we are still not satisfied. I have asked my team to work harder so that India is in the top 50 next year.

“We have also made doing business cheaper. The historic implementation of Goods and Services Tax and other measures of simplification and consolidation of taxes have reduced transaction costs and made processes efficient.

“We have also made doing business faster through digital processes, online transactions and single point inter-faces,” he said.

According to LocalCircles, each person who voted in the survey is registered with the portal with their detailed information and in many cases they shared their residential address.
Doing business in India now easier, cheaper, faster, smarter: Modi

He said his government had made doing business smarter by insisting on IT based transactions and digital payments including direct transfer of government benefits.

Modi added that he understood that being a young nation, India needs to create job opportunities and better infrastructure, which are both linked with investments.

“Therefore, in recent years, there has been unprecedented focus on manufacturing and infrastructure,” he said.

Listing the achievements of his government, he said for the first time, India had become a net exporter of electricity, had installed transmission lines at an unprecedented pace and had doubled the speed of road construction with rural road connectivity now at 90 per cent.

Also Read: PM Narendra Modi to Unveil National Film Museum in Mumbai

“At 7.3 per cent, the average GDP growth, over the entire term of our government, has been the highest of any Indian government since 1991. At the same time,the rate of inflation at 4.6 per cent is the lowest for any Indian government since 1991, when India began its process of liberalisation,” he said.

Modi had conceptualised the summit as Gujarat Chief Minister in 2003 to position the state as an ideal investment destination after the 2002 riots. (IANS)