Universal healthcare – Modi’s biggest gamble

In less than a month’s time India embarks on its most significant social experiment since independence with the introduction of a universal healthcare scheme, the largest in the world.

Covering around 500 million of the giant nation’s poorest citizens, the scheme is officially named the National Health Protection Mission, but has been instantly dubbed Modicare, after Prime Minister Narendra Modi.

With a General Election due in less than a year, that close association carries both benefits and risks for Modi and his ruling Bharatiya Janata Party (BJP).

The scheme has long been a dream of the Prime Minister, who has said that India can reach its true potential only with a healthy population.

“It is essential to ensure that we free the poor of India from the clutches of poverty due to which they cannot afford healthcare,” he said recently.

Brave words, but in India ambitious undertakings have a habit of falling victim to the country’s stifling bureaucracy.

Modi’s promise that every Indian village would have electricity in the first 1000 days of his administration foundered when that date passed with thousands still in the dark.

Public Servants covered over the failure by redefining ‘electrification’ as when power cables from the grid reached a transformer in the village, not when individual homes were connected.

Similarly, efforts to clean up the sacred River Ganges, in many places little more than an open sewer, have been shambolic, with officials saying this year’s deadline was always impossible.

Progress has been bogged down in endless negotiations over where to build sewage treatment plants, while complicated tendering processes have deterred private companies from seeking the projects.

Progress has been made, perhaps more than by any other Government in the country’s history, but Modi’s over-promising and his failure to fulfil the ambitions on which he was elected, could well backfire on him.

So the Prime Minister badly needs a win — and if the implementation of universal health care can be managed successfully it would overshadow the failures.

A study done almost a decade ago named medical costs as one of the primary causes of poverty in India, forcing around 63 million people below the poverty line due to their private healthcare bills.

Modi is relying on the country’s booming economy, the reform of the tax system with the introduction of a Goods and Services Tax last year, and increased foreign investment to fund the plan.

However, many commentators believe that in the short term at least, the major problem will not be money, but the ability of the country’s creaking health infrastructure and lack of qualified medical personnel to cope with what is expected to be a massive increase in demand.

Modicare is a huge political gamble for the Prime Minister, and the fortunes of the BJP in next year’s polls may depend on it.