Get cracking: on implementing ‘Modicare’
The Centre must draw up an implementation roadmap for the new health scheme
The NDA government lost precious time in its first three years in initiating (पहल करना) a health scheme that serves the twin purposes of achieving universal coverage and saving people from high health care costs. It announced two years ago in the Budget a health protection scheme offering a cover of ₹1 lakh per family, but ultimately that did not extend beyond ₹30,000. Fresh hopes have been raised with the announcement of Ayushman Bharat in Budget 2018. The plan has the components of opening health centres for diagnostics, care and distribution of essential drugs as envisaged (उल्लिखित) in the National Health Policy, and a National Health Protection Scheme (NHPS) to provide a cover of up to ₹5 lakh each for 10 crore poor and vulnerable families for hospitalisation. These are challenging goals, given the fragmented (अंश) nature of India’s health system. Some States already purchase health cover for the poor, but do not regulate private secondary and tertiary care services or treatment costs. The task before the Centre, which has provided ₹3,200 crore for the programme areas, is to now draw up an implementation roadmap.
Developing countries that launched universal health coverage schemes over a decade ago, such as Mexico, had to address some key challenges. These included transfer of resources to provinces, recruitment of health personnel, and purchase and distribution of medicines to the chosen units. All these apply to India. Moreover, the steady growth of a for-profit tertiary care sector poses the additional challenge of arriving at a basic care package for those who are covered by the NHPS, at appropriate costs. A national health system will also have to subsume (सम्मिलित करना) all existing state-funded insurance schemes. This will give beneficiaries access not just within a particular State but across the country to empanelled (सूची में सम्मिलित करना) hospitals. In the case of the local health centres that are planned under the Ayushman Bharat programme, there is tremendous potential to play a preventive role by reducing the incidence and impact of non-communicable diseases such as diabetes and hypertension. Such centres can dispense free essential medication prescribed by all registered doctors and procured (प्राप्त) through a centralised agency. But the efficiency of a large-scale health system depends on strict regulation. The early experience with state-funded insurance for the poor shows that some private hospitals may resort to unnecessary tests and treatments to inflate claims. Determination of treatment costs by the government is therefore important. This will also aid those with private health insurance, since it eliminates information asymmetry (असममिति) and provides a comparison point. The Centre must share details of the next steps.
- Initiating: Cause (a process or action) to begin.
Synonyms: begin, start off, commence, take action on, usher in
Antonyms: close (down), phase out, shut (up)
- Envisaged: to form a mental picture of
Synonyms: conceit [chiefly dialect], conceive, conjure (up), dream, imagine, envision, fancy, fantasize, fantasy, feature, ideate, image, picture, see, vision, visualize
- Fragmented: A small part broken off or separated from something.
Synonyms: piece, bit, particle, speck
Antonyms: doctor, fix, heal, mend, patch, rebuild, recondition, reconstruct, renovate, repair
- Subsume: to have as part of a whole
Synonyms: carry, comprehend, contain, embrace, encompass, entail, involve, number, include, take in
Antonyms: exclude, leave (out), miss out [British], omit
- Empanelled: Enrol (someone) on to a jury.
- Procured: Obtain (something), especially with care or effort.
Synonyms: obtain, acquire, get, find, come by, secure, pick up, get possession of
Antonyms: forfeit, lose, give up, hand over, part (with), relinquish, surrender, yield
- Asymmetry: Lack of equality or equivalence between parts or aspects of something; lack of symmetry.
Synonyms: lack of symmetry, non-uniformity, unevenness, crookedness, lopsidedness, contortion, deformity, jaggedness, raggedness, cragginess, indentation
Desert defeat: on Congress victory in Rajasthan
The Rajasthan bypoll victory has given the Congress a ray of electoral hope
Byelections are not clear pointers to the direction of the political wind, even when they are held close to a general election. A host of local factors are often at play, and selection of candidates and civic grievances (शिकायत) exercise as much influence on the voter’s mind as do livelihood concerns and governance issues. Even so, the results of the Rajasthan byelections would have jolted (विचलित) the ruling BJP. The Congress not only won the two Lok Sabha seats and the lone (अकेला) Assembly seat, but it did so with impressive margins. In the 2014 Lok Sabha election the BJP made a complete sweep of Rajasthan, winning all 25 seats. The Congress’s recovery of some of the lost ground reflects a general dissatisfaction with the Vasundhara Raje government. Ms. Raje seems to have paid the price for an imperious (अभिमानी) attitude that alienated (विमुख) large sections within her own party. True, Rajasthan voters have not given either the BJP or the Congress two consecutive terms since the BJP returned to power in 1993. But the Modi wave of 2014 was supposed to have changed the political narrative, with the BJP emerging as a pan-Indian party and the natural party of government. The BJP has lost some Assembly elections since 2014. However, Bihar 2015 was arguably a mere blip (रडार लक्ष्य), more on account of a coming together of a motley (विभिन्न प्रकार का) mix of opposition parties than on account of any erosion in its base. Punjab 2017 was written off as the Akali Dal’s loss rather than the BJP’s own. But in Rajasthan, as in Gujarat where the BJP scraped through in late-2017, the two national parties will be in a straight contest. A defeat can mean only one thing: the BJP is slipping in approval ratings in the run-up to 2019.
A negative vote it may have been, but the verdict is also a vindication (अनुमोदन) of the Congress tactic of letting a young Sachin Pilot be its public face. Many in the party blamed the inability to close the gap with the BJP in Gujarat on the failure to identify a youthful leader, and instead relying entirely on borrowed leaders such as Alpesh Thakor, Hardik Patel and Jignesh Mevani to free it of a jaded (थकाया हुआ) look. If it wants to beat the BJP, the Congress has to find a way to counter its strategy of turning every election into a presidential contest between Prime Minister Modi and Congress president Rahul Gandhi. The byelection results suggest the key to doing so lies in encouraging a youthful regional leadership to emerge in each State. But if the BJP is slipping in Rajasthan, it is gaining in West Bengal: the party finished second behind the Trinamool Congress in the Uluberia Lok Sabha and Noapara Assembly constituencies. With the collapse of the Left Front vote bank, it is the BJP that is emerging as a challenger. But a second-place finish in West Bengal is poor compensation. The BJP’s setback in Rajasthan has given the Congress a ray of electoral hope, as the State goes to the polls later this year.
- Grievances: a lingering ill will towards a person for a real or imagined wrong
Synonyms: down [chiefly British], grudge, resentment, score
Antonyms: approval, endorsement (also indorsement), sanction
- Jolted: a forceful coming together of two things
Synonyms: bump, collision, concussion, crash, impingement, jar, impact, jounce, kick, shock, slam, smash, strike, wallop
- Lone: being the one or ones of a class with no other members
Synonyms: alone, only, one, one-off, singular, sole, solitary, special, sui generis, unique
Antonyms: perennial, recurrent, repeated, adjacent, adjoining, communicating, contiguous, neighboring, next-door, accompanied
- Imperious: fond of ordering people around
Synonyms: authoritarian, authoritative, autocratic (also autocratical), despotic, dictatorial, domineering, bossy, masterful, overbearing, peremptory, tyrannical (also tyrannic), tyrannous
Antonyms: acquiescent, compliant, passive, resigned, submissive, yielding, amenable, docile, obedient, tractable, humble, meek, modest, unassuming
- Alienated: to cause to change from friendly or loving to unfriendly or uncaring
Synonyms: alien, estrange, disaffect, disgruntle, sour
Antonyms: appease, conciliate, disarm, mollify, pacify, placate, propitiate, reconcile
- Blip: A small flashing point of light on a radar screen representing an object.
- Motley: Incongruously varied in appearance or character; disparate.
Synonyms: miscellaneous, disparate, diverse, assorted, sundry, varied, mixed, diversified, heterogeneous
Antonyms: homogeneous, distinct, distinctive, individual, separate
- Vindication: a setting free from a charge of wrongdoing
Synonyms: clearing, exculpation, exoneration, acquittal
Antonyms: conviction, castigation, censure, condemnation, denunciation
- Jaded: depleted in strength, energy, or freshness
Synonyms: all in, aweary [archaic], beat, beaten, bleary, burned-out (or burnt-out), bushed, dead, done, done in, drained, exhausted, fatigued, weary, knackered [British], limp, logy (also loggy), played out, pooped [slang], prostrate, spent, tapped out, tired, tuckered (out), washed-out, wearied, wiped out, worn, worn-out
Antonyms: unwearied, active, energetic, invigorated, peppy, strengthened, strong, tireless, vitalized, weariless