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Times of India
07 April 2010
By Dr Devi Shetty

Our slum dwellers will have access to high–tech healthcare that citizens of First World countries can only dream of, thanks to government healthcare
Dr Shetty
Within seven years India will become the first country in the world to dissociate healthcare from affluence. In the near future we will have an interesting scenario.

Our slum sizes will grow rapidly due to loss of agricultural jobs and huge urban migration. Our slums will have no water, no toilets but when they are unwell, all the slum dwellers will have access to high–tech healthcare with dignity – much better than first world citizens. How will this transformation happen in such a short duration of time?

Providing For All
It’s because the government is gradually becoming a health insurance provider rather than healthcare provider. This started seven years ago with a health insurance programme for the farmers of Karnataka with a premium of Rs 5 and 1.7 million farmers called Yashaswini.

Yashaswini proved that with price of one packet of beedi, you can buy a health insurance and even get a heart operation for free if required. We presented Yashaswini to the exchief minister of Andhra Pradesh who was a doctor by profession. He launched Rajiv Arogyashree which covered nearly 80 per cent of the state’s population holding BPL cards. In the process, the Congress government came back to power with a thumping majority. This encouraged the government of Tamil Nadu to launch Kalaignar insurance to cover nearly 60 per cent of the state population holding BPL card. Kalaignar will definitely have a big impact on the next elections.

Karnataka, the pioneer of micro health insurance, decided to cover the BPL population with Vajpayee Arogyashree.

We are currently helping many state governments with similar schemes.

Providing For All
The other major game changer is going to be ESI. ESI was mandatory for workers drawing a salary of less than Rs 7,000 per month. Now it is extended to Rs 15,000. With the government’s desire to bring unorganised sector also under the health scheme, we will have more than 450 million people under the health coverage, much bigger than the US health market. People have a poor opinion of ESI. As of now, it is the best managed health insurance programme in the county. The only insurance which doesn’t have upper limit to its members.

Why can only India accomplish this task when the US and UK governments are struggling? It’s because we produce the largest number of doctors, nurses and medical technicians in the world. Outside the USA, we have the largest number of US FDA approved drug manufacturing units. We already have built–in capacity to manufacture medicines for the whole world if we are allowed. Our only missing link for perfect healthcare delivery is that people do not have cash to pay for it.

Once the government becomes the health insurance provider than healthcare provider we will change the rules of the game. How sure I am in expecting the government to do this. I have no doubt about this since politicians all across the world do the right things for the wrong reasons.

(Dr Shetty is a renowned cardiac surgeon and chairman of Narayana Hrudayalaya, Bangalore)

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