Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
From UPSC perspective, the following things are important:
Prelims level: Particulars of the scheme
Mains level: Complement this newscard with our previous newscards on the same scheme.
- The National Council of Applied Economic Research labels the ‘proposed beneficiaries of the NHPS’ as “Deprived Households”
- The annual income of these households lurks below Rs1.5 lakh
- Some 135 million households fall in the deprived category, constituting 56% of the total households in India
- And yet, there has appeared not a single report highlighting their opinion
Medical expenses: Deprived households
- On an average, the medical expenses of such deprived households with low income capacity hover between 5-6% of total expenses
- The pursuit of health may trap them in medium- or long-term therapy regimens, pulling this single-digit proportion into a catastrophic range of 10% or above
- Hence, the majority of them do not report sickness, until rendered inactive to work and earn, either by injury or the flare-up of a chronic condition
Hospitalization is not enough
- The top ailments adding the maximum burden of disease on deprived classes include ischaemic heart diseases, lower respiratory tract infections such as bronchitis and asthma, chronic obstructive pulmonary disorder, tuberculosis and diarrhoeal diseases
- Most of these are chronic conditions that require regular outpatient consultations to manage disease prognosis.
- Hospitalization is a one-off event
- Eighty per cent of the time, the out-of-pocket expenditure of patients within this strata is, therefore, on outpatient clinics that don’t come under the ambit of NHPS
- Therefore, for deprived households, the NHPS holds limited value
- It cannot deliver on the grand claim of complete health for them
What should be done?
- The NHPS will not reduce the ever-increasing monthly medical bills that go towards managing the chronic diseases they are most susceptible to
- It will not bring an iota of change in their health-seeking behaviour
- That can happen only if the expenditure on health, which has hovered around 1% of gross domestic product (GDP), doubles in the near future to improve access and quality of healthcare to the last mile
Will there be any benefit of the scheme?
- No doubt, insurance of Rs5 lakh per annum would be a comforting thought if one needs hospitalization and surgical intervention
- Such events may be few and far between