Do We Need 2 Different Healthcare Programs To Effectively Cover India?

The sub-continent is definitely a unity in diversity. The diversity is of caste, colour, creed and of course, class. When it comes to healthcare, India has been a mixed bag. The nation has a rich history with surgeons like Sushruta and physicians like Charaka who healed many in the ancient history. Then came Ayurveda, which many claim has answers to the most of the incurable diseases.

But somewhere in the middle we lost our path. As the village system gave way to the cities, many Indians were actually left without care. The villagers come to cities for earning their daily bread and if they fall ill, they have to depend on their masters to give them medicines. They can't afford the cost of modern healthcare and also, they can't return to their villages for traditional treatment, because they have come too far from their villages. Illness for them means loss of pay which they can ill afford. These type of population in India is countless. The minimum wage in India is set at $689 per annum for a 48 hours work per week. That is 8 hours a day for 6 days. This would come around to $57 a month (Rs.3,500). This also means that leave of absence means loss of pay. In India there are 400 million daily wage workers. So falling ill is not an option.

On the other hand of the picture, there are city dwellers and middle and upper middle class Indians. They can afford to fall ill and take leave from work as they work in large organisations with health benefits or they have enough to pay for these from their pockets. But, the diseases they suffer from are different than the daily wage workers. They suffer from chronic diseases like diabetes, hypertension, cardiac issues. So, in reality, there are 2 Indias. The poorer India and the richer India. The poorer India deals with malnutrition and infectious diseases and the richer India deals with chronic ones.

In this context, the recently announced Universal Healthcare System in India is going to be ideal for the daily wage workers. This program focuses on nutrition, preventive care, primary health and a government insurance system to cover certain procedures. It is going to be launched in April 2015 and it will cover almost whole of the country by 2019. The program would cost around $26 billion (Rs.1.6 trillion) to initiate and then would cost $11.4 billion annually to sustain. The current spend on healthcare is around $5 billion and that would represent 1% of the GDP. It is a very ambitious and necessary program and the Government has taken a brave step to cover the country this way.

Health insurance can be a good option for urban India. They can pay and are more financially literate. So an insurance plan with incentives to keep their chronic diseases parameters under check would be a great idea.

With limited healthcare resources, its best to give them to those who need it and make incentives to others who can avoid using them. So, we need a dual system, Universal Healthcare for the poor and Health Insurance for those who can afford them. We hope that in the days to come, India will definitely have one of the best strong and effective healthcare system.