It is not often that Indian residents want to on-board a scheme for Bharat. If the Rs 5 lakh sum insured under Modicare for 500 million Indian poor reaches its potential, middle India will clamour to be allowed entry and will be willing to pay for the scheme. What costs India an average of 2% of sum insured for individual covers is costing an average of 1.3% to the government currently, and has the potential to drop down further under Modicare.
In announcing Modicare or the National Health Protection Scheme as a government funded secondary and tertiary care (health services that usually require hospitalisation) plan, India has signalled its healthcare direction where the State does not provide free or subsidised medical care but funds insurance companies to reimburse empanelled hospitals (both private and public) that do. We can argue that the State has abdicated its responsibility. We would be technically right but practically wrong. The current public health system is largely dysfunctional not because money is not being spent but because of the structure that has a hub and spoke model. The bottleneck is not the availability of money, but that of doctors and nursing staff. Available doctors are a fraction of the sanctioned doctors, which are a fraction of the required doctors. Throwing more money at the same system is not likely to yield results, hence this approach that builds on the Rashtriya Swasthya Bima Yojana (RSBY) experience.