Odisha's healthcare scheme to face similar challenges of Modicare

Insurance police (File) Representational image

On August 15, when Prime Minister Narendra Modi rolls out the Ayushman Bharat-National Health Protection Mission, a similar healthcare package would be announced in the state of Odisha, too. Unlike other states, Odisha has refused to join the Centre's healthcare scheme, and instead, is going ahead with its own health insurance.

Similar to the Centre's health insurance scheme, Odisha's Biju Swasthya Kalyan Yojana (BSKY) also aims provide an annual cover of Rs 5 lakhs per family for secondary and tertiary care.

The state government intends to subsume all current schemes—Rashtriya Swasthya Bima Yojana, that provides a cover of Rs 30,000, and Biju Krushak Kalyan Yojana that provides a cover of Rs 70,000 and Rs 1 lakh for farmers—into the new scheme.

Like Ayushman Bharat, popularly known as Modicare, Chief Minister Naveen Patnaik is also rolling out BSKY keeping in mind the state elections in 2019.

In this scheme, though the cover amount is the same as that promised by the Centre, the net is being spread a bit wider. Under Ayushman Bharat, the number of eligible beneficiaries in the state would be 61 lakhs, while under BSKY, the state intends to extend the cover to 70 lakh people, says Sarit Kumar Rout, associate professor, Indian Institute of Public Health, Public Health Foundation of India, Bhubaneshwar.

Like most states that are adopting the trust model for Modicare, Odisha also intends to eschew the insurance model, and opt for a trust model to manage the scheme. “This will save the government a lot of money because they wouldn't be paying any premium, as in the insurance model,” says Rout.

The scheme is ambitious, and like Ayushman Bharat, it may encounter several challenges in its roll out. A trust model, for instance, does not have the professional capacity to conduct costing studies, empanel hospitals, and monitor quality of care, says Rout. “These would be initial hiccups in the scheme,” he says.

Besides, access to quality services in the state would be a huge challenge, one that the PM's Ayushman Bharat is bound to encounter as well. Unlike the rest of the country, where approximately 70 per cent of healthcare falls under the private sector, in Odisha, that percentage falls under the public sector, Rout says. “In utilisation of public sector healthcare services, Odisha is the second state after Assam, according to the National Sample Survey Office. Access to these services outside of cities, where the majority lives, will thus be critical for the success of the scheme,” he says. The state government will also have to address shortages of human resources, especially when it comes to the requirement of specialists. “New medical colleges are coming up in districts such as Mayurbhanj and Koraput. The government is also offering more pay to doctors serving in difficult areas to address staff shortages. It will take a few years before shortages will be addressed though,” he says.