Editorial: Rise above politics
Pressing public issues like healthcare for seniors must transcend the political divide
The launch of the expanded Ayushman Bharat health insurance scheme to cover all senior citizens above 70 years, irrespective of their income status, is an important milestone in India’s healthcare landscape. However, its politicisation has added a jarring note to an otherwise laudable initiative. The opposition-ruled Delhi and West Bengal governments have opted out of the scheme, prompting Prime Minister Narendra Modi to remark, during the launch event, that their decision was guided by political interests and that it amounted to depriving free treatment to the elderly patients in the two States. The public spat between the Centre and the opposition-led States should have been avoided as it sends the wrong signals to the people. At least, pressing public issues like healthcare should be kept above politics. The scheme provides health coverage to all senior individuals, regardless of income, who are 70 years of age or above. In addition to 6 crore senior individuals, this extension is expected to help around 4.5 crore families by offering them free health insurance coverage up to Rs 5 lakh per family. The benefits of the system will be available to all senior citizens in this age range, irrespective of their socioeconomic background, with this permission. For senior citizens facing health crises, any opportunity for comprehensive health coverage can be life-changing. The political impasse only undermines their well-being. Healthcare for seniors must transcend the political divide. A pragmatic approach could integrate elements from both the Delhi and Ayushman Bharat models, ensuring efficient, accountable and accessible healthcare across States.
The success of the Ayushman programme will depend on how effectively the broader issues concerning the healthcare system are tackled. In India, it is estimated that a visit to the hospital pushes 5.5 crore people below the poverty line every year. The out-of-pocket expenses dominate the costs and often cripple the families. India’s expenditure on healthcare accounts for just over 1.17% of the GDP, one of the lowest in the world. Unless the public expenditure on healthcare, particularly in semi-urban and rural areas, is increased significantly, the ground realities will remain the same. By 2050, India’s elderly population is expected to double, touching about 320 million and constituting nearly 20% of the total population. Obviously, this will have a profound implication not only for our healthcare system, but for society at large. This demographic shift would result in an increasing need for long-term care, especially for chronic illnesses such as diabetes, arthritis and heart disease. Unfortunately, India’s healthcare infrastructure remains ill-equipped to meet these needs, especially in rural areas where access to care is already limited. Expanding the Ayushman scheme without increasing public healthcare funding could result in States cutting costs, leading to poor-quality care, especially in economically weaker regions. The scheme’s sustainability depends on how well the State governments implement it.