KEY HIGHLIGHTS:

  • PM Modi’s flagship programme has allocated merely Rs. 2000 Crore to provide insurance to 40% of India’s population. This would amount to a measly Rs.40 person p.a.! Furthermore, Ayushmann also focuses only on secondary and tertiary healthcare, ignoring the fact that 70% of Indians seek primary healthcare. Finally, only 3 out of 100 persons treated under such schemes get cashless treatment.
  • NDA Limits Access to Essential Medicine: Essential medicine’s pricing has been delinked from price control, making necessary medicines unaffordable. Prices of only 10% of medicines in the market are being regulated by the government.
  • The budget for Reproductive and Child Health (RCH) programme was slashed by 30%, while funds for control of Communicable diseases were drastically downsized by 27%. In this situation of massive budget cuts, it is no wonder that children’s health has been affected, and communicable diseases like encephalitis (responsible for most deaths in the Gorakhpur tragedy) have remained unchecked.
  • Contravening a Supreme Court judgement, NDA’s NMC bill increases management quota in medical education by over 50%, thus enhancing the scope of capitation fees and reducing access to affordable medical education, especially for SC/ST/OBCs.
  • NDA’s Unscientific Medical Plan for India: NDA’s proposed NMC bill also allowed Ayurvedic, Unani & Homeopathy (AYUSH) practitioners to undertake a six month bridge course, and then practice allopathic medicine. This puts patients at risk, and also undermines traditional systems of healthcare.

CHARGE 1: NDA OVERSEES ANTI-HEALTH POLICIES

  • The NDA slashed the healthcare budget by 20% in 2014-’15. In 2015-’16, it was further slashed by 5.7%. This continued in 2016-’17. The NDA also slashed the budget for the Reproductive and Child Health programme by 30% in 2018-’19. Furthermore, communicable diseases like encephalitis (responsible for most deaths in Gorakhpur tragedy) are unchecked because allocations to control the spread of such diseases were slashed by 27%.
  • The Modi government has covertly started privatising the ICDS scheme, which severely impacts the 27 lakh women who are working as anganwadi workers and helpers in nearly 14 lakh anganwadi and mini-anganwadi centres throughout India.
  • Contravening a Supreme Court judgement mandating that 85% seats must be regulated by government (leaving the rest to management quota), the NDA’s NMC bill has made this 50-50 and thus further commercialising medical education. This a) enhances the possibility of capitation fees, and b) reduces access to affordable medical education, especially to SC/ST/OBCs.
  • BJP governments have not expanded free medicine programmes at all. In fact, the BJP government in Rajasthan tried to cut budgets and downsize the successful “Chief Minister’s Free Medicine Scheme”, which had been introduced by the previous Congress government in the state.

CHARGE 2: NDA HAS ENSURED EXPLOITATION OF PATIENTS

  • In stark contrast to the erstwhile Planning Commission’s High Level Expert Group (HLEG) recommendations, the NDA’s Ayushmann Bharat scheme pushes an insurance based model of healthcare a) covers only 50 crore people, which excludes over half of India’s population; b) focuses only on secondary and tertiary healthcare, ignoring preventive, promotive, and primary healthcare. This is unconscionable given 80% of people accessing healthcare need primary healthcare, with only 20% requiring secondary and tertiary healthcare.
  • Only 2000 crore have been allocated to Ayushmann Bharat, which would amount to Rs.40 person p.a.. In stark contrast, the NDA has spent more than Rs. 4000 crores on PR alone.
  • Ayushmann Bharat is dependent on patients approaching empanelled larger private hospitals, which are mostly concentred in metros and large cities. This scheme effectively excludes those in rural India.
  • Only 3 out of 100 persons treated under such schemes get cashless treatment, as per a study based on NSSO data looking at hospitalisation cases. Ayushmann Bharat will only guarantee unbridled profits to the insurance companies, which has been the experience with the PM Fasal Bima Yojana.
  • The Clinical Establishment Act, which is meant to regulate private hospitals, has remained on paper under the NDA. For example, the hospital standards have not been notified by the NDA over the last five years. Consequently, private hospitals have been blatantly profiteering at the expense of ordinary Indians.
  • According to a report of the National Pharmaceutical Pricing Authority (NPPA) published in February 2018, private hospitals in Delhi and NCR made a whooping 1700% profit on drugs, consumables and diagnostics. Modi Government has not taken any action against profiteering by private hospitals.
  • Based on NITI Aayog’s recommendation, Drug Price Control order was to be delinked from National List of Essential Medicines. Consequently, prices of essential medicines are no longer controlled. Since November 2016, India experienced higher inflation in medicine price than normal inflations. Only 10% medicine are under price control.