Earlier this year, Indian Prime Minister Narendra Modi revealed a new health insurance policy titled Ayushman Bharat, or “Long Life India.” Described by him as an initiative “unparalleled in terms of scale and extent,” the program was launched Sunday alongside extensive media promotion. Calling it “a historic day for India,” Modi symbolically handed out free medical treatment cards.
Dubbed “Modicare” by many, the program is designed to aid its poorest 500 million citizens, making impoverished families eligible to receive up to $7,000 (500,000 rupees) per year in medical costs. While this insurance scheme seems revolutionary at first, the most important part of any insurance policy is the fine print. And upon closer inspection, the many flaws of Modicare become clear.
There are multiple reasons to be skeptical, with the most glaring issue being that of cost. Although the goal is to cover the costs of 500 million people (and 500,000 rupees annually per person), the government has only set aside 200 billion rupees, essentially leaving only one in 125,000 people to benefit from this program before it runs out of money. In response to outrage by critics, Indu Bhushan, the CEO of Ayushman Bharat, insisted that the treasury had committed to giving more upon request. But with initial funding so low, it seems implausible that Modi will ramp up the system so rapidly as to cover all 500 million people. The whole of the program takes up a measly 0.1 percent of GDP per year, hardly “unparalleled in terms of scale and extent.”
Critics and medical experts alike, however, have questioned whether the program will be successful even without the issue of funding. India’s 1.3 billion citizens currently rely on less than 60,000 hospitals, many of them dilapidated and in urgent need of repair. Furthermore, Modicare doesn’t include primary healthcare. Instead, the program focuses on secondary and tertiary care, meaning that locally endemic diseases and common injuries, which make up the majority of most medical costs in developing countries, will remain a burden to poorer families.
Another backbone of Modicare is its promise to upgrade 150,000 health sub-centers. Yet, with 81 percent of all doctors in the country working in private healthcare, leaving public hospitals underfunded and understaffed, this seems like another empty promise intended to appease citizens.
Others fear that this is simply another one of Modi’s tricks to gain more popularity amongst the public. This boost is desperately needed; a Gallup Poll reports that from 2014 to 2017, the number of Indians who considered themselves “thriving” decreased from 14 percent to three percent. The value of the rupee hit an all-time low in August of this year, falling below the 70 INR to 1 USD mark for the first time in the 70 years since India’s independence. And although low-skilled workers are satisfied with Modi for the most part, they’ve received on average a 22 percent wage cut, even as the GDP grew at an annual rate of 8.2 percent.
With the next election expected before May 2019, Modi has meticulously cultivated his image as a politician for the poor, introducing many policies designed to help the impoverished. If his primary motivation in introducing Modicare was only to boost his approval ratings, then he will likely succeed at his goal. By the time a feasible financial and physical model could be worked out, the election could well be over. If the program then fails under the rule of the next prime minister, Modi might subsequently displace the responsibility, essentially eliminating his opposition and increasing his own popularity. Two birds, one stone.
Taken at face value, Modicare seems to be the crowning achievement in Modi’s political career that could change the lives of millions of impoverished Indians. A more detailed look into the system, however, reveals that inadequate funding and infrastructure will likely pockmark Modicare until its end. Though it’s too early to tell the how the situation will turn out, we should remain wary of Modicare’s ambiguous terms and suspicious promises. For now, it seems that Prime Minister Modi will be content with the temporary burst of popularity that Modicare brings him.
Neil Shen is a Junior from Vancouver, Canada. Contact the author at fshen22@andover.edu
