Challenges beset Modicare

The National Health Protection Scheme (NHPS) aka Modicare announced by Finance Minister Arun Jaitley in this year’s Budget is a good initiative and a welcome move. Under this plan, christened as ‘Ayushman Bharat’, the central government will cover 100 million poor families and 500 million people, providing each family an insurance cover of up to Rs 5 lakh per year for secondary and tertiary care or for hospitalisation. The scheme is estimated to cost the government exchequer about Rs 10,000 crore annually.

In India, the secondary and tertiary care penetration is abysmally low with per capita expenditure on healthcare at Rs 13,000 compared with China at Rs 37,000, not to mention the USA at Rs 5,75,250 and the UK at Rs 2,10,275 respectively; an initiative of this kind is the need of the hour. The central government’s intent to include poor people from rural, peri-urban and urban areas in the healthcare ecosystem is a step in the right direction and is praiseworthy.

Successful implementation of any such scheme is the hallmark of availability of adequate financial resources, infrastructure and skilled manpower besides business-friendly regulatory environment. So, also is the deployment of technology, particularly in the 21st century where Artificial Intelligence (AI), M2M, Internet of Things (IoT) and Big Data is simplifying things and playing an enabler’s role in developing solutions to find answers to day-to-day problems, thereby making a huge impact on people’s lives and businesses alike.

It is here, though, that people may be somewhat sceptical about the successful implementation of such schemes in the present context. Lack of understanding apart; given that, the contours of the full scheme have not yet been shared in the public domain, there may be concerns about how well the scheme may fulfil its objectives. Such scepticism may emanate from the lack of healthcare infrastructure in the country where doctor-to-patient ratio stands at 1:1674 against WHO guidelines of 1:1000. India needs 30 lakh hospital beds to achieve the desired target of 3 beds for every 1000 people. As per an estimate, the country needs 10,54,000 doctors and 2,40,000 nurses and other para-medical staff to meet the growing demand for healthcare. Clearly, there is a huge gap between the desired infrastructure and required trained manpower respectively and current availability of the same in the country.

Originated by Albert S Humphrey, SWOT (Strength, Weakness, Opportunity and Threat) is a tool used in business context to discover strengths, weaknesses and opportunities; and manage and eliminate threats of an idea, product, service or solution in the marketplace.

Strength

NHPS brings the government to the forefront and positions it in the leadership role to address a core priority area in the country which has been experiencing a huge demand and supply challenge. The scheme is expected to play the role of a catalyst in health care education, leveraging technology, development of entrepreneurship, growth of PPP model in health care and investment in the sector. If implemented well, it also has the promise to significantly bring down the disease burden on a young nation on one hand and health-care cost burden on poor people on the other. It also augurs well for much-needed job creation and encouragement to entrepreneurship, particularly in PPP model in the country.

Weakness

NHPS is unlikely to yield the desired outcomes of bridging the healthcare divide in the nation due to shortage of healthcare infrastructure, non-availability of adequate trained manpower – both medics as well as paramedics, without adequate leverage of technology; and non-availability of funding due to hitherto lack of government support.

Opportunity

NHPS offers a great opportunity for deployment of technology to create a digitised healthcare ecosystem to remove the bottlenecks of poor health care infrastructure and shortage of trained manpower in the country thereby making healthcare services available and accessible more pervasively in the country and more importantly, it has the potential to ensure inclusion of the masses in a cost-effective and government-funded healthcare system.

Threat

The biggest threat to any such program is the inability of key stakeholders to implement it well – not having the ability to execute flawlessly is not an option. NHPS is no exception to this. Bureaucracy, central and state agencies, entrepreneurs, insurance companies, hospitals, doctors, pathology laboratories, diagnostic centres and political class (with bipartisan approach) must collaborate to make this scheme successful.

Modicare is yet another systemic change the government proposes to invest heavily into, albeit, without adequate infrastructure and skilled manpower in place.  However, adoption of technology to mitigate these bottlenecks and more importantly, to develop a digitized healthcare ecosystem comprising of doctors, diagnostics and pharmacy stores, coupled with Indian entrepreneurship spirit and encouragement to PPP model is likely to help bridge the healthcare divide in the country.

Anand Garg is a  business leader with experience in Healthcare, Office Automation, Automotive, Renewable Energy and Telecom Infrastructure