Indias Health Care Sector Finally Gets Its Tipping Point

As we all know now, the Indian government’s big and bold vision for India’s health care needs is going to be realised through the ambitious ‘Ayushman Bharat Programme’. This would be the world’s largest government-funded health programme, drafted for 100 million poor families with Rs500,000 ($7,700; Dh28,245) in allocations per year per family. It seems that the government is now moving from the “ease of doing business” to the “ease of living” for the poor and middle-class.
The three major challenges to overcome in order that the scheme is meaningfully successful would be access to health care, funding and providing quality health care.

Challenge 1

The first step for NHPS would be to strengthen infrastructure in government hospitals before allowing — or even considering — strategic participation from the private players. For one, a universal health insurance only through private hospitals has not worked for the poor anywhere. Secondly, the government has an existing network of rural and urban health care through its primary health centres and community health centres.

Accordingly, for greater accessibility to health care, the centre plans to have one medical college for every three parliamentary constituencies and about 150,000 new health and wellness centres providing comprehensive health care — NCDs, maternal and child services, free drugs and diagnostics.

India has 644 districts, and hence 232 health centres per district on an average. The number 232 per district is a good density. Obviously, health centres will be set up based on the density of population and not only by number districts.

Considering the 1.3 billion population of India, there will be one health centre per 8,666 people. Since the Ayushman Bharat Programme is as of now only for 100 million families, 400 million to 500 million people are required to be under the cover. This means the government is going to set up one health centre per 3,333 people. This is a fair number to start with.

Challenge 2

Now let us check on the finances for the scheme. The health care scheme has a potential to be a gamechanger for India’s health industry and can generate substantial growth in insurers’ premiums. As per the finance secretary Hasmukh Adhia, the government expects the scheme to cost only about $1.5 billion to $1.8 billion (Dh5.5 billion to Dh6.61 billion) annually, with estimates of Rs1,000-Rs1,200 as insurance premium per household.

It is expected to be rolled out in six to eight months. The latest federal budget, however, has announced initial allocation of Rs20 billion for the scheme. Yet, in the coming year(s), we foresee a comfortable situation on the revenue side because the graphs as far as direct tax is concerned would move very fast and the volumes might help in shrinking the premium further.

Furthermore, Rajiv Kumar, vice-chairman of Niti Aayog, a policy think-tank of the government, had said that revenue from the 1 per cent additional cess would be enough to meet the funding needs. 
Only caution and discipline needs to be put into the thought and action while planning to roll out the scheme as the challenge will be in scheme implementation and, most importantly, its governance.


Challenge 3

Now that access to health care and finances seems to be all sorted, at least theoretically, the provision for delivering quality health care is an issue on everyone’s mind.

Since the scheme covers hospitalisation and services in the secondary-tertiary space of the health care delivery, the doctors and nurses, technicians and the medical staff at health centres are required to be trained for a higher level of delivery so that the screening of patients for the higher referrals centres is done intelligently.

The development of digital technologies represents a huge opportunity to transform the health care sector in a way that increases efficiency as well as quality. The West had been at the forefront of the adoption of such advancements.

As per Moore’s Law, the power of computing is doubling every year. Hence, to scale up the skill levels of a doctor may take some time, but to scale up technologies would not. Today, medical technologies are working as a second pair of dependable eyes, analysing mass data while trying to find the patterns in the signs and symptoms of the diseases.

We see the larger part of the equation building up on the sly, via data-driven technologies in trying to recognise patterns that would warn early signs of the diseases. Health care and technology go hand in hand and would always do.

India is considered by many as a future start-up destination in a whole lot of industries. Our institutes of technology, like our defence labs, can produce some amazing patented products at an unbelievably low price to address the technological needs ensuring success to this health scheme.

Prasanth Manghat is CEO of NMC Health.