“Even a whisper becomes noise when the potential is 500 million people,”  says the co-founder of one of the largest Indian healthcare startups. And there are many interested in that potential number. The conference rooms of Niti Aayog and the health ministry in central Delhi are always occupied. Visitors include representatives of international organisations including the World Bank and the World Health Organisation, health tech startups, insurers, hospital associations, IT companies, and of course, consulting companies, who want to design the programme touted as ‘the world’s largest’.

Many decisions to be made in the coming months (Source: people in the know in the the government and industry)

The Ayushman Bharat-National Health Protection Mission (AB-NHPM) a.k.a Modicare, with its $1.54 billion budget (allocated for the next two years to impact 500 million people), has sent ripples through the healthcare sector.

The Association of Health Providers India (AHPI), which represents the majority of Indian hospitals, has been discussing the details with the health ministry. And the ministry has invited all major health insurers to design a cost-effective insurance product. Medical equipment companies such as Abbott Healthcare and Medtronic India have asked Niti Aayog if the scheme would require purchases. Microsoft has made a presentation at Niti Aayog pitching their cloud technology. Finally, major consulting companies—Accenture, Deloitte, Ernst & Young, KPMG and PriceWaterhouseCoopers—have offered to create the blueprint for Ayushman Bharat.

Unfortunately, these conversations are meaningless at this stage, said the representative of a Chicago-based medical equipment manufacturer, because they often go something like this: “We ask them ‘How do you plan to execute this scheme?’. The reply is:  ‘We have no idea, just yet. Why don’t you help us out?’” “So we have decided to wait for the government to figure it out; it looks like they are working in reverse,” he added.

The announcement came first. And the details? They may come later.

The scheme was announced on 1 February, after which, the cabinet approved the budget in March. In April, Prime Minister Narendra Modi inaugurated a part of the scheme and put together a team to work out the details.

The CEO in-charge of implementing the scheme, Indu Bhushan, has apparently been chosen due to his experience, specifically with international financial institutions such as World Bank and Asian Development Bank, Health Sciences from Johns Hopkins University and the Indian bureaucracy. Also, he is overworked. So are a few informal working groups as they race to try and launch the scheme by 15 August. If not, then on 2 October.

Bhushan’s biggest struggle in designing the scheme is the use of information technology to ensure that the scheme’s two pillars—health and wellness centres and the Rs 5-lakh health insurance cover—are used by the patient as they should be—for outpatient and inpatient care, respectively.


Ruhi Kandhari

Ruhi writes on the impact of healthcare policies, trends in the healthcare sector and developments on the implementation of Electronic Health Records in India. She has an M. Sc. in Development Studies from the London School of Economics.

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