What is “Modicare" and Why Should You Care?

On February 1, 2018, finance minister Arun Jaitley announced the National Health Protection Scheme (NHPS) which is dubbed “Modicare” and touted as the world’s largest healthcare scheme.

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NHPS aims at providing healthcare services to about 100 million families in India under which each will get insurance coverage of Rs. 5 lakhs. It targets 500 million individuals, i.e. roughly 41% of the entire population, that come from a financially weak background.
Three types of healthcare services will be provided under NHPS, which are:

• Primary care: It covers basic medical care and treatments for common illnesses and health problems.
• Secondary Care: Under this, healthcare services will be provided by skilled medical practitioners for various treatments as well brief stays in the hospitals for serious illnesses.
• Tertiary care: This will cover healthcare services that require specialist doctors. Under this, treatments will be provided for terminal illnesses and acute pain, etc.

The following are some of the most important things to know about the NHPS:

• Mr. Jaitley pointed a survey that showed that the people in India have to spend as much as Rs. 26,000 for treatments in private hospitals. However, under “Modicare”, the government estimates that the families will have to pay to pay around Rs. 1,100 only.
• “Modicare” will offer an insurance ceiling of Rs. 5 lakhs per family. However, over time more funds will be made available.
• “Modicare” will cover nearly 40% of the entire population and take us closer to the goal of “universal health coverage”.
• Experts estimate that “Modicare” will set the exchequer back by Rs. 1 lakh crores. Since 40% of the incurring costs will be borne by the states (60% will be covered by the union government) the huge financial imposition may not sit well with them.
• There is already an affordable healthcare scheme for the public called the Rashtriya Swasthya Bima Yojana (RSBY). However, it provides an insurance ceiling of Rs. 30,000 only. Also, 75% of its costs are borne by the center and 25% by the states.