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India Wants to Give Half a Billion People Free Health Care

409 points by poloolop 9y ago

known 9y ago
Indian regime should impose 30% Inheritance Tax to fund the free healthcare
- gkgicccj 9y ago
  Your rate is stupid and so is the idea. Those who are rich will get away without paying, just like here. Those who need money will end up paying. Remember all these tax the rich schemes tax anything but the rich
  - glhaynes 9y ago
    Welp, I guess the rich can never be taxed. Which is why they're always fine with laws that raise their taxes!
thisisit 9y ago
I just hope it works very well because it seems every year there is one new populist measure. There is already: a. Food Security which provides food to nearly 2/3rd of the population or 820 million people. b. Minimum Support prices for grains which was hiked in this budget. Farmers also get loan waivers. c. National Rural Employment Guarantee which provides employment to over 100 million people
- vthallam 9y ago
  It's not a populist mesaure. You need this while you find a way to modernize agriculture practices so that the 60% who depend on farming won't have tough times. Also, there's enough money for all these schemes while still maintaining a decent fiscal deficit. What has to be worked on is the delivery of these. For better or worse linking Aadhar to bank accounts and delivering the benefits directly into the bank accounts helped to certain extent.
  - thisisit 9y ago
    What exactly is your definition of a populist measure? and please state your sources for the claim that there is enough money, not only for these programs but others too, while still maintaining the fiscal deficit.
  - Squareplums 9y ago
    If agriculture is modernized, it will need less men and will lead to more rural unemployment and hardships, no? Need to take measures so that 60% population should not depend on agriculture
- dv_dt 9y ago
  Universal healthcare is cast as a 'populist' measure in the US. But if you look at data of cost of healthcare for nations applying universal healthcare vs those who do not in developed nations, India might rationally look at it as an economic efficiency measure. Agricultural supports also can be looked at with a political filter, but the US provides government back agricultural insurance as a positive economic measure. Otherwise there may be a dwindling population of farmers and farming companies and increased food instability. One could argue about private vs publically funding these stabilization and boosting measures but it's much simpler/stabler to provide some forms long term guarantees via gov't policy than hoping a private market does it and does it correctly (without wiping out or consuming their customers). Are all these measures the same? No, but you have to look deeper than populist bad, private markets good.
  - thisisit 9y ago
    Isn't universal healthcare that all people and communities have the same access to healthcare? India's population is 1.3 billion and this says it will cover 500 million people. So, it doesn't cover all people and communities. It covers some part of the population. Let's say Obamacare covered only a specific section of US what would have happened then? To clarify my stand here, I am in favor of Universal Healthcare but not this. Edit: I saw your edit on agriculture later. So, let me count that out too. We should do everything to support agriculture but the whole policy is skewed towards grains and every bump happens helps to ingrain the fact that grains good but vegetables bad. Do we really want that? So, I am in favor of a policy which works for all and not for specific sections which at least Indian laws tend to do.
    - digikata 9y ago
      The ACA did only cover a section of the US. 27 million were (are?) uninsured under the ACA. https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/ https://www.kff.org/uninsured/fact-sheet/key-facts-about-the... I don't know the right answer on specifics of agricultural policy. I wish grains were less emphasized in US agricultural supports - but I also acknowledge that there is a built up knowledge base, and capital momentum around grains and the efficiency of food systems (as a total system around citizen health), isn't trivial. You have to trade off energy->food, caloric efficiency, and total health just to name a few factors.
- vkou 9y ago
  If ensuring people have access to food and water is populist, I'm pretty sure I don't want to live in whatever libertarian utopia is the converse.
ethagknight 9y ago
>> The health care plan, part of the government’s 2018-19 budget presented on Thursday, would offer 100 million families up to 500,000 rupees, or about $7,860, of coverage each year. Thats roughly $800B dollars, or over 30% of India's GDP. What am I missing? Most people won't participate? EDIT: according to the article, the Finance Ministry has allocated $314 million (or 4 hundredths of a percent of the theoretical max total benefit). As in, the funding they acknowledge is non-existent.
- ucaetano 9y ago
  That's "up to", my guess is that most families will only use a small fraction of that, especially because services might not be available or covered.
- shubhamjain 9y ago
  Providing coverage doesn't mean that everyone would be availing the full amount every year. That's the fundamental principle of insurance business.
- shripadk 9y ago
  Quoting from the article: As part of the budget proposal, Mr. Jaitley said the government would levy a surtax that would raise about $1.7 billion a year specifically for health care programs.
- govg 9y ago
  Well, the idea behind offering insurance is that you typically don't need to account for everyone claiming it at the same time.
- randcraw 9y ago
  500M people times $7860/yr is $3.93 trillion (the max possible coverage). But if only $314M is authorized, the average person will receive only 314M/500M, or about 63 cents.
  - shripadk 9y ago
    That's not how you calculate when it comes to insurance. You can't divorce life from maths. In your calculations you are assuming 500 million people will all fall ill at the same time and each will claim the full $7860 for the year which is next to impossible. In my opinion, $314 million is more than enough for now unless India is struck by an epidemic.
ucaetano 9y ago
Giving free healthcare is a good step, but the important question is how good will it be and how much will be covered. Brazil has 100% of its population (210M people) covered by free, single-payer, universal healthcare, resulting in a life expectancy of 75 years (US is 79, Japan and Switzerland with 83 IIRC). But your experience can vary dramatically. It all depends on how much money is actually being put on it (in healthcare-costs-PPP-adjusted $/capita).
- maym86 9y ago
  Still much better then no healthcare if you couldn't afford it before.
  - ucaetano 9y ago
    Oh, sure, no question about that.
- mickelsen 9y ago
  Not necessarily a counterpoint but Chile's dual system -private and public, both with copay for most- gives them a life expectancy of 81.79 years, surpassing a lot of more developed countries with free universal healthcare.
  - ucaetano 9y ago
    Brazil's is also dual, everyone gets covered by the public system, but there are plenty of private systems. And Chile is always a special case, the combination of natural resources, small population and good public systems does wonder for the country. Despite the extreme differences, I tend to compare Chile to the Nordic countries more than with LatAm. Not sure if that's scalable to larger countries, which is always the big question.
    - sol_remmy 9y ago
      > And Chile is always a special case, the combination of natural resources, small population and good public systems does wonder for the country. Despite the extreme differences, I tend to compare Chile to the Nordic countries more than with LatAm. You are flat out wrong with this comparison. Chile has one of the lowest tax burdens in the world. It can be accurately compared to either Hong Kong or Singapore. Average tax burden by country: https://files.taxfoundation.org/legacy/docs/OECD_Tax_Wedge_Charts-04.png https://files.taxfoundation.org/legacy/docs/OECD_Tax_Wedge_C... Scandinavian countries have 4x higher taxes than Chile. They are polar opposites.
sukhadatkeereo 9y ago
I highly recommend reading this answer to understand the Indian budget better. I hope this helps clear a few questions. https://www.quora.com/How-do-you-see-the-union-budget-2018-19-presented-by-Arun-Jaitley/answer/Balaji-Viswanathan-2?share=e00f6859&srid=CQoI https://www.quora.com/How-do-you-see-the-union-budget-2018-1...
dominotw 9y ago
One of my uncles got paralyzed on his whole left side of body because of carelessness of govt hospital, lack of sanitation, corruption, and the general don't give a fuck attitude of the employees( if they cared to show up to work in the first place). There is a running joke in India that "You can only go to a govt hospital" implication being that you'd not return alive. I suspect this is another scheme concocted to gobble up public money via corruption. A gift that would keep giving for decades to come. For politicians to promise jobs in bureaucracy to their caste members. Ofcourse, Nytimes piece mentions none of this in its effort to push "See even India has 'free' healthcare" ideology.
- shripadk 9y ago
  Your point, though accurately describes most government run hospitals, misses the crucial piece of information: This insurance is for Private run hospitals not government run hospitals (which is free anyways). Quoting from the article: If passed by the Indian Parliament and properly funded, the new program would be a vast expansion of health coverage, allowing people to visit the country’s many private hospitals for needs as varied as cancer treatment and knee replacements. Although government-run hospitals are theoretically free for everyone, the waits are long, quality is poor and corruption is endemic.
- sumedh 9y ago
  > There is a running joke in India that "You can only go to a govt hospital" implication being that you'd not return alive. I have never heard this joke atleast in Mumbai or Pune.
  - dominotw 9y ago
    Do you or your folks go to govt hospitals?
    - sumedh 9y ago
      I have not been treated in govt hospital if that is what you are asking but I have been to govt hospitals to check up friends and others who were treated there.
nodesocket 9y ago
I can't see how India is going to afford this. As stated in another comment it could cost up to $800B dollars, which is 30% of India's GDP. If this causes India to have financial issues as a country, it's their own fault for not doing basic accounting and number crunching.
- i0exception 9y ago
  That's like saying if everyone maxes out their health insurance, insurance companies will go out of business. In any given year, not everyone is going to use the ~$8000 allocated to them. Also, healthcare in India is cheap. $8000 goes a long way.
  - dingo_bat 9y ago
    > healthcare in India is cheap. $8000 goes a long way. Yeah I think ₹5 lakh is excessive. I have a ₹2 lakh cover for me and my wife and unless we both are diagnosed with bone cancer simultaneously we are in no danger of maxing it out.
- shripadk 9y ago
  Yes it would cost $800B dollars if all 100 million insured fall ill at the same time and use the entire 5 lakh rupees allocated: which is highly unlikely. This is pretty much how insurance works in any part of the world. The only difference here is that it's allocated out of tax payer money.
holydude 9y ago
We got free healthcare in europe that i pay for with atrociously high taxes. Yet whenever i actually need to visit a doctor i always go to a private one.
- baby 9y ago
  oh, where do you find private doctors in France?
  - holydude 9y ago
    I do not know I do not live in France.
    - baby 9y ago
      You said europe like it represents every country
  - chimeracoder 9y ago
    > oh, where do you find private doctors in France? Most doctors in France are private practitioners. They may or may not draw some (or all) of their revenue from insurance, which is partly funded by the government, but not fully (only a little more than 70% of health costs, in the aggregate).
- groby_b 9y ago
  Let me translate that: "I sure have a lot of money". The point is having a doctor available for everybody, not just the people who can afford it. Yes, those of us who make more money pay more for it, in the form of taxes. Ultimately, you'll need to decide if you want to care only about your wellbeing, or about society's wellbeing.
  - jasonlotito 9y ago
    > The point is having a doctor available for everybody Not necessarily in a timely manner, which is important for things like Autism (and because of the belief in the system, can actually harm the person). Even if you can afford it, you don't necessarily get to see a doctor, even with years long wait times. And even if you see a doctor, the actual service they provide might be worthless (e.g. suggesting you put your child in an institution and forget about it). This is just my experience dealing with the Canadian healthcare system in Montreal. Moving to the US provided cheaper, faster, and superior results in every metric.
t1o5 9y ago
To be read as - the elections are coming. Mr Modi is seeking a second term. https://en.wikipedia.org/wiki/2018_elections_in_India https://en.wikipedia.org/wiki/2018_elections_in_India NYT article to be read in tandem with this one https://www.reuters.com/article/us-india-budget/with-elections-coming-up-indias-government-will-aim-to-woo-rural-voters-in-budget-idUSKBN1FH0GJ https://www.reuters.com/article/us-india-budget/with-electio...
- Feniks 9y ago
  Is there something wrong with that? The guy who introduced social security for the elderly and in my country got a statue in Parliament.
- rajathagasthya 9y ago
  It's okay for Mr. Modi to take advantage of that in the elections if it benefits 500M people. That's what every politician does.
- chris_wot 9y ago
  If Mr Modi has rolled out free health care to 500 million people, saving millions of lives, probably a good thing and I hope it wins him some votes!
  - t1o5 9y ago
    India already has free healthcare for all the citizens. Its just that its not efficient and well managed. https://en.wikipedia.org/wiki/Healthcare_in_India https://en.wikipedia.org/wiki/Healthcare_in_India
tejaswiy 9y ago
The govt. of Andhra Pradesh (a state in India) has pioneered a state backed insurance program several years ago with reasonable success (https://en.wikipedia.org/wiki/Aarogyasri https://en.wikipedia.org/wiki/Aarogyasri). The problem however with these programs is that corruption within the healthcare industry is still endemic and doctors create fake diagnoses and perform unnecessary surgeries on patients to get their reimbursements from Aarogya-sri. If this program is to be rolled out a national scale, the govt. needs to address the systematic corruption in the healthcare industry first. That said, I think Aarogyasri was overall a huge success in my state and has saved millions of lives and I'm excited to see it being adopted at a national level.
- kumarm 9y ago
  Definitely Aarogyasri in AP saved millions of Lives. Current administration tried to remove the program since its not introduced by them and can't take credit for. So they are trying to kill it slowly (By removing people from program, cutting benefits etc). I wonder what will happen to this Free Health insurance program when central government changes next time.
  - horsecaptin 9y ago
    Isn't the current government conservative and pro-business? If the are the ones implementing free healthcare, then why should the leftist opposition want to remove it? I bet they'll try to undermine it at every stage well before they ever get power. That will make it easy to kill or fix it when they do get power back.
    - IanDrake 9y ago
      According to the article, there already is free healthcare provided by the government. The problem is that model, predictably, sucks. “Although government-run hospitals are theoretically free for everyone, the waits are long, quality is poor and corruption is endemic.” So the left doesn’t want private healthcare providers to show them up.
perseusprime11 9y ago
Cheap, fast and great generally don’t go together. Depending on the problem, you have to pick either one or two but not all three. It will be interesting to see how this experiment pans out in India. I wholeheartedly wish success for them because this is something we have to put behind our back before we enter the next decade.
FairDune 9y ago
Why is this posted on HN?
allpratik 9y ago
Until the details are revealed, I won't buy this. It seems to have been introduced to take advantage of upcoming elections. The reason I'm skeptical about this step is because there are simply no specific blueprint whatsoever. And with recent government implementations, their biggest failure turns out to be ambiguity. Good example is GST. After it's launch several month's ago, almost every big/small industry is finding it hard to get the specific details. I highly doubt about government's ability to implement it. This insurance should have been given on basis of economical standing. Choosing a random 500M number is good for making headlines but again it is not clear on who will gain this insurance benefits?, what will be covered?, how to claim it? I foresee, "divide and rule" :p On another note, please have a look at Sensex. It's near all time high. The reason behind such rally is not FII but DII. Infact, FII has actively removed over $20Bn since 2015. There was slight influx of FII money post two months of demonetisation but again outflow increased in following months. But still Sensex didn't crashed because of the counter balance from DII or read it as mostly mutual fund companies. Also, I had noticed an increased expenditure in mutual fund investment ads on TV and almost all types of media. And these ads were sponsored mostly by govt bodies and associations. There is nothing wrong to invest in mutual funds. But when I heard about long term and short term capital gains tax today, things got much clearer for me as to why DII raised some much cash in very short period of time. To check the validity of above numbers, you can refer to sensex related stats on moneycontrol.com and check out the YoY sensex FII/DII activity. It has a very well explanatory chart about it.
- shripadk 9y ago
  > Good example is GST. After it's launch several month's ago, almost every big/small industry is finding it hard to get the specific details. I don't get what problems does industry have with regards to GST apart from simpler return filing and changes in rates. The implementation was itself smoother than expected. Just compare with other countries that implemented GST and you'll realise that it took almost 2 years for things to stabilize. Comparatively, the implementation and addressal of most issues took only few months! Today, Hasmukh Adhia also hinted at automatic preparation of GST returns and simplification of invoice entry by directly entering details into the system which is pretty amazing if you ask me. I'm actually quite happy with how GST has shaped. Especially when compared to other governmental bodies which have error prone systems. I have faced no issues filing GSTR-3B returns and with simplification of GSTR-1 and GSTR-2 I guess all worries are taken care of.
whack 9y ago
A key paragraph from the article which better explains the finances behind this policy: "The health care plan ... would offer 100 million families up ... $7,860, of coverage each year. That sum, while small by Western standards, would be enough to cover the equivalent of five heart surgeries in India." It's much easier to provide universal healthcare, when medical costs are low. Finding ways to bring down costs in the US, would go a long way towards improving the healthcare situation here.
- yesforwhat 9y ago
  China, too
- deleted 9y ago
  [deleted]
jimjimjim 9y ago
in a lot of countries having a government provided health care system (with private if you wish to pay more for quicker/better) is Normal rather than a political idea that only 1 side is allowed to support.
devnonymous 9y ago
This is a blatant lie. The devil is in the details and the detail is there has been no specific funds allocated in the budget for this nor are there any specifics about how the funds will be allocated in the future.[1] This is just a vague expression of intent. Precisely the type that every politician will make when in desperate need of good will - exactly what Modi is in need of. [1] thread about this https://twitter.com/Memeghnad/status/959026718722768896 https://twitter.com/Memeghnad/status/959026718722768896
- statguy 9y ago
  This. To add to this, PM Modi and the current administration habitually make grandiose promises and setting up new schemes with a lot of fanfare just in time for key elections. When the elections are won, the promises and schemes are quietly forgotten.
- devnonymous 9y ago
  To whoever downvoted, here's an exercise -- download all the pdfs from http://www.indiabudget.gov.in/index.asp http://www.indiabudget.gov.in/index.asp do a quick search in any of the documents for "National Health Protection Scheme" and let us know if you find it any where other than the speech.
otempomores 9y ago
Maybe in a caste society where such extremes coexist and in a post human labour world.. ah sort of shared misery socialism is preferable to beeing burned alive rich in varanasi
padobson 9y ago
to 500,000 rupees, or about $7,860, of coverage each year. That sum, while small by Western standards, would be enough to cover the equivalent of five heart surgeries in India. If something like this is implemented, I'm curious to see what it does to prices - will a heart surgery continue to cost less than $2,000? Healthcare seems like a supply problem to me, not a demand one. Where healthcare is affordable, demand should be stable year-to-year. It seems like what's needed is more doctors and devices, not more ways to pay.
- mgbmtl 9y ago
  > If something like this is implemented, I'm curious to see what it does to prices - will a heart surgery continue to cost less than $2,000? In most countries, the cost of such operations are fixed by the state (ex: Canada). > "Where healthcare is affordable, demand should be stable year-to-year. What do you mean? There are so many factors that could explain higher healthcare costs, including an aging population, or better health coverage. I'm also not sure what it means for healthcare to be affordable. In most countries, the cost seems proportional to the general wealth. The US might be the exception, since it's one of the few countries with great wealth disparity and with a non-universal system (more bureaucratic overhead/costs).
111_1_111 9y ago
Unless India plans to enslave doctors, I don't see how they could possibly give out healthcare for free.
themihai 9y ago
To have any chance of success they should fix the corruption first, otherwise it will become yet another way to waste taxpayers' money.
dmix 9y ago
I really dislike when professional journalists call it "free healthcare", this should really needs to stop. It's not free, half the country will be paying for it with their taxes. In countries with public healthcare up to a third of their taxes expenditure goes to healthcare services, it's a significant expense and far from 'free'. Journalists should really start using "public healthcare" or "public health insurance", otherwise they are making their agenda quite clear. And I say that in support of gov subsidized health insurance.
- jimmaswell 9y ago
  This is a pointless and pedantic complaint. It's obvious to everyone what "free healthcare" means. Words have multiple meanings, and free in this context means tax-funded. Prescriptive language policing never works.
- skinnymuch 9y ago
  Everyone knows what free healthcare means. They know it means it’ll come from taxes. Otherwise they are just furthering an agenda? That seems like quite a stretch.
- Brakenshire 9y ago
  The US government spends as much as a percentage of GDP on healthcare as the UK, and a lot of the other countries which provide free universal healthcare. The marginal increase in healthcare coverage could actually be free, given the massive inefficiencies which exist in the current system.
- eugeniub 9y ago
  Somehow people insisting "don't say free" never extend this demand to free libraries, free fire department service, and so on. Virtually everyone who has even a minor understanding of how society works intuitively understands that "free healthcare" is paid for with public money, just like "free libraries" are paid for with public money. In fact, calling it "public health insurance" makes it actually more ambiguous and confusing. It sounds like access to it is open to anyone, like how access to a bookstore is open to anyone. "Free" is less ambiguous as to how much it costs to the person receiving the service.
zaroth 9y ago
TFA: “India’s government spent just 1.4 percent of the country’s gross domestic product on health care in 2014, little changed as a proportion of the economy in 20 years, according to the World Bank. China, by contrast, spent 3.1 percent of its G.D.P. on health care in 2014; the United States spent 8.3 percent in the same year.” CMS.gov: “U.S. health care spending grew 4.3 percent in 2016, reaching $3.3 trillion or $10,348 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 17.9 percent.” World Bank puts total health care expenditure at 17.1% for the US in 2014 and 4.6% for India... They must mean just US government spending, not counting private expenditure. https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?end=2014&locations=US&start=1995&view=chart https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?end=2014...
- dragonwriter 9y ago
  CMS is reporting total US healthcare spending; TFA is discussing government healthcare spending; total (federal, state, and local) government spending was 45.2% of all health expenditures in the US [0], which applied to the 17.9% of GDP for total US healthcare expenditures gives 8.1% GDP public expenditures in 2016, very similar to the 8.3% TFA reports for 2014. EDIT: Ah, my post crossed your edit, which recognizes the issue, but: > They must mean just US government spending, not counting private expenditure. The part you quote from TFA explicitly says it is comparing government expenditures. [0] from the same CMS page you seem to be using: https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html https://www.cms.gov/research-statistics-data-and-systems/sta...
thetruthseeker1 9y ago
They say Proof is in the pudding. I am wary of applauding before seeing how well this is implemented. India is known to come up with lot of big programs that make good rhetoric, but not all of them are implemented with equal amount of vigor or commitment. I am sure part of the motivation may be to help next election cycle which is coming soon.
debt 9y ago
I love that that's not even half of India.
anuraj 9y ago
This is a sham. There is no specific allocation for the same in the budget. State Governments have been instituting insurance cover for population for ages and it is available around the same quantum. Generally insurance in India like any other country has the effect of artificially inflating healthcare cost. India would do well to spend money on improving public health infrastructure instead.
- anuraj 9y ago
  http://www.firstpost.com/business/budget-2018-arun-jaitleys-modicare-health-scheme-is-music-to-the-ears-of-50-crore-indians-but-its-too-good-to-be-real-4332001.html http://www.firstpost.com/business/budget-2018-arun-jaitleys-...
exabrial 9y ago
India has 1,320m people. This headline is slightly concerning, given the caste system in place that engineers poverty. Who is paying for it and who is getting the benefit?
pankajdoharey 9y ago
For a population of 1.3 Billion this is less than half the population. Other countries cover 100% population with such schemes. https://en.wikipedia.org/wiki/List_of_countries_by_health_insurance_coverage https://en.wikipedia.org/wiki/List_of_countries_by_health_in...
IncRnd 9y ago
The article reads as if this is health insurance, however it uses both terms health care and health insurance. Those are entirely different from each other. One believes that preventative care will increase health, limiting the need for procedures and pills. The other believes that one can pay a lower premium (possibly through the state), betting on getting sick. These are opposite of each other. I'm not saying this is bad - just that people have to know what is being discussed, or inevitably people will be disappointed.
crimsonalucard 9y ago
India doesn't get it. Defending the world from terrorism is 1000x more important then basic health insurance. How can health insurance defend the people against suicide bombers? The only thing that can defend people from suicide bombers is the 1.5 Trillion dollar F-35, the greatest war plane ever made.
- gandutraveler 9y ago
  Number of people dying in india due to health is ~1000x more than ones killed in terrorism.
  - crimsonalucard 9y ago
    I was being sarcastic.
thewhitetulip 9y ago
I might be sounding negative, but the current PM is known to be someone who just promises a million things. This is just a prop for 2019 because he has absolutely destroyed the economy and the RBI. I seriously doubt if this will actually be implemented ever. This is the magic of India, They won't deny insurance, but when the people will go to create insurance, there will be some or the other issue with the system and they won't be able to apply for it. Also the media is a sycophant of the govt so nobody will question it and on the exterior, it'll be shown that they did provide insurance although nobody got anything.
known 9y ago
Half-baked https://qz.com/1195447/budget-2018-what-students-from-iim-jnu-and-isb-thought-of-arun-jaitleys-budget/ https://qz.com/1195447/budget-2018-what-students-from-iim-jn...
Compurx 9y ago
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409 points by poloolop 9y ago

known 9y ago

Indian regime should impose 30% Inheritance Tax to fund the free healthcare

gkgicccj 9y ago
Your rate is stupid and so is the idea. Those who are rich will get away without paying, just like here. Those who need money will end up paying. Remember all these tax the rich schemes tax anything but the rich
- glhaynes 9y ago
  Welp, I guess the rich can never be taxed. Which is why they're always fine with laws that raise their taxes!

thisisit 9y ago

I just hope it works very well because it seems every year there is one new populist measure. There is already: a. Food Security which provides food to nearly 2/3rd of the population or 820 million people. b. Minimum Support prices for grains which was hiked in this budget. Farmers also get loan waivers. c. National Rural Employment Guarantee which provides employment to over 100 million people

vthallam 9y ago
It's not a populist mesaure. You need this while you find a way to modernize agriculture practices so that the 60% who depend on farming won't have tough times. Also, there's enough money for all these schemes while still maintaining a decent fiscal deficit. What has to be worked on is the delivery of these. For better or worse linking Aadhar to bank accounts and delivering the benefits directly into the bank accounts helped to certain extent.
- thisisit 9y ago
  What exactly is your definition of a populist measure? and please state your sources for the claim that there is enough money, not only for these programs but others too, while still maintaining the fiscal deficit.
- Squareplums 9y ago
  If agriculture is modernized, it will need less men and will lead to more rural unemployment and hardships, no? Need to take measures so that 60% population should not depend on agriculture
dv_dt 9y ago
Universal healthcare is cast as a 'populist' measure in the US. But if you look at data of cost of healthcare for nations applying universal healthcare vs those who do not in developed nations, India might rationally look at it as an economic efficiency measure. Agricultural supports also can be looked at with a political filter, but the US provides government back agricultural insurance as a positive economic measure. Otherwise there may be a dwindling population of farmers and farming companies and increased food instability. One could argue about private vs publically funding these stabilization and boosting measures but it's much simpler/stabler to provide some forms long term guarantees via gov't policy than hoping a private market does it and does it correctly (without wiping out or consuming their customers). Are all these measures the same? No, but you have to look deeper than populist bad, private markets good.
- thisisit 9y ago
  Isn't universal healthcare that all people and communities have the same access to healthcare? India's population is 1.3 billion and this says it will cover 500 million people. So, it doesn't cover all people and communities. It covers some part of the population. Let's say Obamacare covered only a specific section of US what would have happened then? To clarify my stand here, I am in favor of Universal Healthcare but not this. Edit: I saw your edit on agriculture later. So, let me count that out too. We should do everything to support agriculture but the whole policy is skewed towards grains and every bump happens helps to ingrain the fact that grains good but vegetables bad. Do we really want that? So, I am in favor of a policy which works for all and not for specific sections which at least Indian laws tend to do.
  - digikata 9y ago
    The ACA did only cover a section of the US. 27 million were (are?) uninsured under the ACA. https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/ https://www.kff.org/uninsured/fact-sheet/key-facts-about-the... I don't know the right answer on specifics of agricultural policy. I wish grains were less emphasized in US agricultural supports - but I also acknowledge that there is a built up knowledge base, and capital momentum around grains and the efficiency of food systems (as a total system around citizen health), isn't trivial. You have to trade off energy->food, caloric efficiency, and total health just to name a few factors.
vkou 9y ago
If ensuring people have access to food and water is populist, I'm pretty sure I don't want to live in whatever libertarian utopia is the converse.

ethagknight 9y ago

>> The health care plan, part of the government’s 2018-19 budget presented on Thursday, would offer 100 million families up to 500,000 rupees, or about $7,860, of coverage each year. Thats roughly $800B dollars, or over 30% of India's GDP. What am I missing? Most people won't participate? EDIT: according to the article, the Finance Ministry has allocated $314 million (or 4 hundredths of a percent of the theoretical max total benefit). As in, the funding they acknowledge is non-existent.

ucaetano 9y ago
That's "up to", my guess is that most families will only use a small fraction of that, especially because services might not be available or covered.
shubhamjain 9y ago
Providing coverage doesn't mean that everyone would be availing the full amount every year. That's the fundamental principle of insurance business.
shripadk 9y ago
Quoting from the article: As part of the budget proposal, Mr. Jaitley said the government would levy a surtax that would raise about $1.7 billion a year specifically for health care programs.
govg 9y ago
Well, the idea behind offering insurance is that you typically don't need to account for everyone claiming it at the same time.
randcraw 9y ago
500M people times $7860/yr is $3.93 trillion (the max possible coverage). But if only $314M is authorized, the average person will receive only 314M/500M, or about 63 cents.
- shripadk 9y ago
  That's not how you calculate when it comes to insurance. You can't divorce life from maths. In your calculations you are assuming 500 million people will all fall ill at the same time and each will claim the full $7860 for the year which is next to impossible. In my opinion, $314 million is more than enough for now unless India is struck by an epidemic.

ucaetano 9y ago

Giving free healthcare is a good step, but the important question is how good will it be and how much will be covered. Brazil has 100% of its population (210M people) covered by free, single-payer, universal healthcare, resulting in a life expectancy of 75 years (US is 79, Japan and Switzerland with 83 IIRC). But your experience can vary dramatically. It all depends on how much money is actually being put on it (in healthcare-costs-PPP-adjusted $/capita).

maym86 9y ago
Still much better then no healthcare if you couldn't afford it before.
- ucaetano 9y ago
  Oh, sure, no question about that.
mickelsen 9y ago
Not necessarily a counterpoint but Chile's dual system -private and public, both with copay for most- gives them a life expectancy of 81.79 years, surpassing a lot of more developed countries with free universal healthcare.
- ucaetano 9y ago
  Brazil's is also dual, everyone gets covered by the public system, but there are plenty of private systems. And Chile is always a special case, the combination of natural resources, small population and good public systems does wonder for the country. Despite the extreme differences, I tend to compare Chile to the Nordic countries more than with LatAm. Not sure if that's scalable to larger countries, which is always the big question.
  - sol_remmy 9y ago
    > And Chile is always a special case, the combination of natural resources, small population and good public systems does wonder for the country. Despite the extreme differences, I tend to compare Chile to the Nordic countries more than with LatAm. You are flat out wrong with this comparison. Chile has one of the lowest tax burdens in the world. It can be accurately compared to either Hong Kong or Singapore. Average tax burden by country: https://files.taxfoundation.org/legacy/docs/OECD_Tax_Wedge_Charts-04.png https://files.taxfoundation.org/legacy/docs/OECD_Tax_Wedge_C... Scandinavian countries have 4x higher taxes than Chile. They are polar opposites.

sukhadatkeereo 9y ago

I highly recommend reading this answer to understand the Indian budget better. I hope this helps clear a few questions. https://www.quora.com/How-do-you-see-the-union-budget-2018-19-presented-by-Arun-Jaitley/answer/Balaji-Viswanathan-2?share=e00f6859&srid=CQoI https://www.quora.com/How-do-you-see-the-union-budget-2018-1...

dominotw 9y ago

One of my uncles got paralyzed on his whole left side of body because of carelessness of govt hospital, lack of sanitation, corruption, and the general don't give a fuck attitude of the employees( if they cared to show up to work in the first place). There is a running joke in India that "You can only go to a govt hospital" implication being that you'd not return alive. I suspect this is another scheme concocted to gobble up public money via corruption. A gift that would keep giving for decades to come. For politicians to promise jobs in bureaucracy to their caste members. Ofcourse, Nytimes piece mentions none of this in its effort to push "See even India has 'free' healthcare" ideology.

shripadk 9y ago
Your point, though accurately describes most government run hospitals, misses the crucial piece of information: This insurance is for Private run hospitals not government run hospitals (which is free anyways). Quoting from the article: If passed by the Indian Parliament and properly funded, the new program would be a vast expansion of health coverage, allowing people to visit the country’s many private hospitals for needs as varied as cancer treatment and knee replacements. Although government-run hospitals are theoretically free for everyone, the waits are long, quality is poor and corruption is endemic.
sumedh 9y ago
> There is a running joke in India that "You can only go to a govt hospital" implication being that you'd not return alive. I have never heard this joke atleast in Mumbai or Pune.
- dominotw 9y ago
  Do you or your folks go to govt hospitals?
  - sumedh 9y ago
    I have not been treated in govt hospital if that is what you are asking but I have been to govt hospitals to check up friends and others who were treated there.

nodesocket 9y ago

I can't see how India is going to afford this. As stated in another comment it could cost up to $800B dollars, which is 30% of India's GDP. If this causes India to have financial issues as a country, it's their own fault for not doing basic accounting and number crunching.

i0exception 9y ago
That's like saying if everyone maxes out their health insurance, insurance companies will go out of business. In any given year, not everyone is going to use the ~$8000 allocated to them. Also, healthcare in India is cheap. $8000 goes a long way.
- dingo_bat 9y ago
  > healthcare in India is cheap. $8000 goes a long way. Yeah I think ₹5 lakh is excessive. I have a ₹2 lakh cover for me and my wife and unless we both are diagnosed with bone cancer simultaneously we are in no danger of maxing it out.
shripadk 9y ago
Yes it would cost $800B dollars if all 100 million insured fall ill at the same time and use the entire 5 lakh rupees allocated: which is highly unlikely. This is pretty much how insurance works in any part of the world. The only difference here is that it's allocated out of tax payer money.

holydude 9y ago

We got free healthcare in europe that i pay for with atrociously high taxes. Yet whenever i actually need to visit a doctor i always go to a private one.

baby 9y ago
oh, where do you find private doctors in France?
- holydude 9y ago
  I do not know I do not live in France.
  - baby 9y ago
    You said europe like it represents every country
- chimeracoder 9y ago
  > oh, where do you find private doctors in France? Most doctors in France are private practitioners. They may or may not draw some (or all) of their revenue from insurance, which is partly funded by the government, but not fully (only a little more than 70% of health costs, in the aggregate).
groby_b 9y ago
Let me translate that: "I sure have a lot of money". The point is having a doctor available for everybody, not just the people who can afford it. Yes, those of us who make more money pay more for it, in the form of taxes. Ultimately, you'll need to decide if you want to care only about your wellbeing, or about society's wellbeing.
- jasonlotito 9y ago
  > The point is having a doctor available for everybody Not necessarily in a timely manner, which is important for things like Autism (and because of the belief in the system, can actually harm the person). Even if you can afford it, you don't necessarily get to see a doctor, even with years long wait times. And even if you see a doctor, the actual service they provide might be worthless (e.g. suggesting you put your child in an institution and forget about it). This is just my experience dealing with the Canadian healthcare system in Montreal. Moving to the US provided cheaper, faster, and superior results in every metric.

t1o5 9y ago

To be read as - the elections are coming. Mr Modi is seeking a second term. https://en.wikipedia.org/wiki/2018_elections_in_India https://en.wikipedia.org/wiki/2018_elections_in_India NYT article to be read in tandem with this one https://www.reuters.com/article/us-india-budget/with-elections-coming-up-indias-government-will-aim-to-woo-rural-voters-in-budget-idUSKBN1FH0GJ https://www.reuters.com/article/us-india-budget/with-electio...

Feniks 9y ago
Is there something wrong with that? The guy who introduced social security for the elderly and in my country got a statue in Parliament.
rajathagasthya 9y ago
It's okay for Mr. Modi to take advantage of that in the elections if it benefits 500M people. That's what every politician does.
chris_wot 9y ago
If Mr Modi has rolled out free health care to 500 million people, saving millions of lives, probably a good thing and I hope it wins him some votes!
- t1o5 9y ago
  India already has free healthcare for all the citizens. Its just that its not efficient and well managed. https://en.wikipedia.org/wiki/Healthcare_in_India https://en.wikipedia.org/wiki/Healthcare_in_India

tejaswiy 9y ago

The govt. of Andhra Pradesh (a state in India) has pioneered a state backed insurance program several years ago with reasonable success (https://en.wikipedia.org/wiki/Aarogyasri https://en.wikipedia.org/wiki/Aarogyasri). The problem however with these programs is that corruption within the healthcare industry is still endemic and doctors create fake diagnoses and perform unnecessary surgeries on patients to get their reimbursements from Aarogya-sri. If this program is to be rolled out a national scale, the govt. needs to address the systematic corruption in the healthcare industry first. That said, I think Aarogyasri was overall a huge success in my state and has saved millions of lives and I'm excited to see it being adopted at a national level.

kumarm 9y ago
Definitely Aarogyasri in AP saved millions of Lives. Current administration tried to remove the program since its not introduced by them and can't take credit for. So they are trying to kill it slowly (By removing people from program, cutting benefits etc). I wonder what will happen to this Free Health insurance program when central government changes next time.
- horsecaptin 9y ago
  Isn't the current government conservative and pro-business? If the are the ones implementing free healthcare, then why should the leftist opposition want to remove it? I bet they'll try to undermine it at every stage well before they ever get power. That will make it easy to kill or fix it when they do get power back.
  - IanDrake 9y ago
    According to the article, there already is free healthcare provided by the government. The problem is that model, predictably, sucks. “Although government-run hospitals are theoretically free for everyone, the waits are long, quality is poor and corruption is endemic.” So the left doesn’t want private healthcare providers to show them up.

perseusprime11 9y ago

Cheap, fast and great generally don’t go together. Depending on the problem, you have to pick either one or two but not all three. It will be interesting to see how this experiment pans out in India. I wholeheartedly wish success for them because this is something we have to put behind our back before we enter the next decade.

FairDune 9y ago

Why is this posted on HN?

allpratik 9y ago

Until the details are revealed, I won't buy this. It seems to have been introduced to take advantage of upcoming elections. The reason I'm skeptical about this step is because there are simply no specific blueprint whatsoever. And with recent government implementations, their biggest failure turns out to be ambiguity. Good example is GST. After it's launch several month's ago, almost every big/small industry is finding it hard to get the specific details. I highly doubt about government's ability to implement it. This insurance should have been given on basis of economical standing. Choosing a random 500M number is good for making headlines but again it is not clear on who will gain this insurance benefits?, what will be covered?, how to claim it? I foresee, "divide and rule" :p On another note, please have a look at Sensex. It's near all time high. The reason behind such rally is not FII but DII. Infact, FII has actively removed over $20Bn since 2015. There was slight influx of FII money post two months of demonetisation but again outflow increased in following months. But still Sensex didn't crashed because of the counter balance from DII or read it as mostly mutual fund companies. Also, I had noticed an increased expenditure in mutual fund investment ads on TV and almost all types of media. And these ads were sponsored mostly by govt bodies and associations. There is nothing wrong to invest in mutual funds. But when I heard about long term and short term capital gains tax today, things got much clearer for me as to why DII raised some much cash in very short period of time. To check the validity of above numbers, you can refer to sensex related stats on moneycontrol.com and check out the YoY sensex FII/DII activity. It has a very well explanatory chart about it.

shripadk 9y ago
> Good example is GST. After it's launch several month's ago, almost every big/small industry is finding it hard to get the specific details. I don't get what problems does industry have with regards to GST apart from simpler return filing and changes in rates. The implementation was itself smoother than expected. Just compare with other countries that implemented GST and you'll realise that it took almost 2 years for things to stabilize. Comparatively, the implementation and addressal of most issues took only few months! Today, Hasmukh Adhia also hinted at automatic preparation of GST returns and simplification of invoice entry by directly entering details into the system which is pretty amazing if you ask me. I'm actually quite happy with how GST has shaped. Especially when compared to other governmental bodies which have error prone systems. I have faced no issues filing GSTR-3B returns and with simplification of GSTR-1 and GSTR-2 I guess all worries are taken care of.

whack 9y ago

A key paragraph from the article which better explains the finances behind this policy: "The health care plan ... would offer 100 million families up ... $7,860, of coverage each year. That sum, while small by Western standards, would be enough to cover the equivalent of five heart surgeries in India." It's much easier to provide universal healthcare, when medical costs are low. Finding ways to bring down costs in the US, would go a long way towards improving the healthcare situation here.

yesforwhat 9y ago
China, too
deleted 9y ago
[deleted]

jimjimjim 9y ago

in a lot of countries having a government provided health care system (with private if you wish to pay more for quicker/better) is Normal rather than a political idea that only 1 side is allowed to support.

devnonymous 9y ago

This is a blatant lie. The devil is in the details and the detail is there has been no specific funds allocated in the budget for this nor are there any specifics about how the funds will be allocated in the future.[1] This is just a vague expression of intent. Precisely the type that every politician will make when in desperate need of good will - exactly what Modi is in need of. [1] thread about this https://twitter.com/Memeghnad/status/959026718722768896 https://twitter.com/Memeghnad/status/959026718722768896

statguy 9y ago
This. To add to this, PM Modi and the current administration habitually make grandiose promises and setting up new schemes with a lot of fanfare just in time for key elections. When the elections are won, the promises and schemes are quietly forgotten.
devnonymous 9y ago
To whoever downvoted, here's an exercise -- download all the pdfs from http://www.indiabudget.gov.in/index.asp http://www.indiabudget.gov.in/index.asp do a quick search in any of the documents for "National Health Protection Scheme" and let us know if you find it any where other than the speech.

otempomores 9y ago

Maybe in a caste society where such extremes coexist and in a post human labour world.. ah sort of shared misery socialism is preferable to beeing burned alive rich in varanasi

padobson 9y ago

to 500,000 rupees, or about $7,860, of coverage each year. That sum, while small by Western standards, would be enough to cover the equivalent of five heart surgeries in India. If something like this is implemented, I'm curious to see what it does to prices - will a heart surgery continue to cost less than $2,000? Healthcare seems like a supply problem to me, not a demand one. Where healthcare is affordable, demand should be stable year-to-year. It seems like what's needed is more doctors and devices, not more ways to pay.

mgbmtl 9y ago
> If something like this is implemented, I'm curious to see what it does to prices - will a heart surgery continue to cost less than $2,000? In most countries, the cost of such operations are fixed by the state (ex: Canada). > "Where healthcare is affordable, demand should be stable year-to-year. What do you mean? There are so many factors that could explain higher healthcare costs, including an aging population, or better health coverage. I'm also not sure what it means for healthcare to be affordable. In most countries, the cost seems proportional to the general wealth. The US might be the exception, since it's one of the few countries with great wealth disparity and with a non-universal system (more bureaucratic overhead/costs).

111_1_111 9y ago

Unless India plans to enslave doctors, I don't see how they could possibly give out healthcare for free.

themihai 9y ago

To have any chance of success they should fix the corruption first, otherwise it will become yet another way to waste taxpayers' money.

dmix 9y ago

I really dislike when professional journalists call it "free healthcare", this should really needs to stop. It's not free, half the country will be paying for it with their taxes. In countries with public healthcare up to a third of their taxes expenditure goes to healthcare services, it's a significant expense and far from 'free'. Journalists should really start using "public healthcare" or "public health insurance", otherwise they are making their agenda quite clear. And I say that in support of gov subsidized health insurance.

jimmaswell 9y ago
This is a pointless and pedantic complaint. It's obvious to everyone what "free healthcare" means. Words have multiple meanings, and free in this context means tax-funded. Prescriptive language policing never works.
skinnymuch 9y ago
Everyone knows what free healthcare means. They know it means it’ll come from taxes. Otherwise they are just furthering an agenda? That seems like quite a stretch.
Brakenshire 9y ago
The US government spends as much as a percentage of GDP on healthcare as the UK, and a lot of the other countries which provide free universal healthcare. The marginal increase in healthcare coverage could actually be free, given the massive inefficiencies which exist in the current system.
eugeniub 9y ago
Somehow people insisting "don't say free" never extend this demand to free libraries, free fire department service, and so on. Virtually everyone who has even a minor understanding of how society works intuitively understands that "free healthcare" is paid for with public money, just like "free libraries" are paid for with public money. In fact, calling it "public health insurance" makes it actually more ambiguous and confusing. It sounds like access to it is open to anyone, like how access to a bookstore is open to anyone. "Free" is less ambiguous as to how much it costs to the person receiving the service.

zaroth 9y ago

TFA: “India’s government spent just 1.4 percent of the country’s gross domestic product on health care in 2014, little changed as a proportion of the economy in 20 years, according to the World Bank. China, by contrast, spent 3.1 percent of its G.D.P. on health care in 2014; the United States spent 8.3 percent in the same year.” CMS.gov: “U.S. health care spending grew 4.3 percent in 2016, reaching $3.3 trillion or $10,348 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 17.9 percent.” World Bank puts total health care expenditure at 17.1% for the US in 2014 and 4.6% for India... They must mean just US government spending, not counting private expenditure. https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?end=2014&locations=US&start=1995&view=chart https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?end=2014...

dragonwriter 9y ago
CMS is reporting total US healthcare spending; TFA is discussing government healthcare spending; total (federal, state, and local) government spending was 45.2% of all health expenditures in the US [0], which applied to the 17.9% of GDP for total US healthcare expenditures gives 8.1% GDP public expenditures in 2016, very similar to the 8.3% TFA reports for 2014. EDIT: Ah, my post crossed your edit, which recognizes the issue, but: > They must mean just US government spending, not counting private expenditure. The part you quote from TFA explicitly says it is comparing government expenditures. [0] from the same CMS page you seem to be using: https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html https://www.cms.gov/research-statistics-data-and-systems/sta...

thetruthseeker1 9y ago

They say Proof is in the pudding. I am wary of applauding before seeing how well this is implemented. India is known to come up with lot of big programs that make good rhetoric, but not all of them are implemented with equal amount of vigor or commitment. I am sure part of the motivation may be to help next election cycle which is coming soon.

debt 9y ago

I love that that's not even half of India.

anuraj 9y ago

This is a sham. There is no specific allocation for the same in the budget. State Governments have been instituting insurance cover for population for ages and it is available around the same quantum. Generally insurance in India like any other country has the effect of artificially inflating healthcare cost. India would do well to spend money on improving public health infrastructure instead.

anuraj 9y ago
http://www.firstpost.com/business/budget-2018-arun-jaitleys-modicare-health-scheme-is-music-to-the-ears-of-50-crore-indians-but-its-too-good-to-be-real-4332001.html http://www.firstpost.com/business/budget-2018-arun-jaitleys-...

exabrial 9y ago

India has 1,320m people. This headline is slightly concerning, given the caste system in place that engineers poverty. Who is paying for it and who is getting the benefit?

pankajdoharey 9y ago

For a population of 1.3 Billion this is less than half the population. Other countries cover 100% population with such schemes. https://en.wikipedia.org/wiki/List_of_countries_by_health_insurance_coverage https://en.wikipedia.org/wiki/List_of_countries_by_health_in...

IncRnd 9y ago

The article reads as if this is health insurance, however it uses both terms health care and health insurance. Those are entirely different from each other. One believes that preventative care will increase health, limiting the need for procedures and pills. The other believes that one can pay a lower premium (possibly through the state), betting on getting sick. These are opposite of each other. I'm not saying this is bad - just that people have to know what is being discussed, or inevitably people will be disappointed.

crimsonalucard 9y ago

India doesn't get it. Defending the world from terrorism is 1000x more important then basic health insurance. How can health insurance defend the people against suicide bombers? The only thing that can defend people from suicide bombers is the 1.5 Trillion dollar F-35, the greatest war plane ever made.

gandutraveler 9y ago
Number of people dying in india due to health is ~1000x more than ones killed in terrorism.
- crimsonalucard 9y ago
  I was being sarcastic.

thewhitetulip 9y ago

I might be sounding negative, but the current PM is known to be someone who just promises a million things. This is just a prop for 2019 because he has absolutely destroyed the economy and the RBI. I seriously doubt if this will actually be implemented ever. This is the magic of India, They won't deny insurance, but when the people will go to create insurance, there will be some or the other issue with the system and they won't be able to apply for it. Also the media is a sycophant of the govt so nobody will question it and on the exterior, it'll be shown that they did provide insurance although nobody got anything.

known 9y ago

Half-baked https://qz.com/1195447/budget-2018-what-students-from-iim-jnu-and-isb-thought-of-arun-jaitleys-budget/ https://qz.com/1195447/budget-2018-what-students-from-iim-jn...

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