The NDA government’s new national health programme which is likely to roll out early next year may provide for free treatment of only those people who are poor and have below poverty live (BPL) cards. Others will have to be insured under the upcoming National Health Assurance Mission (NHAM) which will replace the existing National Health Mission (NHM). At the parliamentary election earlier this year, the Bharatiya Janata Party (BJP)-led alliance had promised to replace existing NHM with a better scheme where the government will provide assurance instead of insurance to people.
Under NHAM, people can avail of free 50 medicines, 30 diagnostics, and almost 40 facilities coming under AYUSH. It will be free for people in the BPL category while people above the line will have to pay 33 percent of the total charge. For them, the government will pay 33 percent and the insurance company will pay the remaining amount.
Now, it gradually becomes clear what the new health model would be. A senior clinical pharmacologist, Ranjit Roy Chaudhury, who is familiar with the preparation of the new health model, says patients who approach a primary health centre (PHC) can avail all facilities free of cost. In secondary and tertiary care also, people coming under BPL will get a few facilities free of cost. For the same treatment, others will have to pay 33 percent. When asked why only 50 medicines will be provided free of cost when states like Rajasthan and Kerala are providing 500 medicines free of cost, he said the new model is for those states that are not providing any medicine free of cost. This is the minimum if few states want to provide more, they can, he adds.
- According to Budget estimates for 2012-13, the Centre gives a subsidy of Rs 18.53 per kg on rice and Rs 14.07 per kg on wheat for BPL category. A BPL family gets 35 kg of foodgrain (rice and wheat) a month.
- Such a family either can get 25 kg of rice and 10 kg of wheat or 25 kg of wheat and 10 kg of rice. Obviously, more rice translates into a higher subsidy.
- The subsidy is defined as the economic cost minus Central issue price. Central issue price is the price at which the foodgrain is allocated to States, while the economic cost is the combination of minimum support price and various other charges incurred by the Centre in procuring foodgrain.
- Thanks to the increase in minimum support price and other charges, the economic costs are increasing.
- However, the Central issue price for BPL has not been revised since July 25, 2000.
- This has resulted in an increase in food subsidy every year. This is not just with rice or wheat. Even for sugar, the Centre pays a levied price of Rs 19.50 per kg to millers while issuing sugar to the States at Rs 13.50 a kg. This issue price has not been revised for a decade.
- After the Centre allocates rice, wheat, and sugar to States, they fix the retail price after taking margins for wholesalers/retailers, transportation charges, levies, local taxes etc into account.