Health coverage – India can learn from Tamil Nadu

Health coverage - What India must learn from Tamil Nadu Health Schemes

The high point of this year’s Union Budget was the prominence given to health—the Budget has promised universal health coverage.

Modicare :-

  • The National Health Protection Scheme (NHPS), called Modicare by the finance minister, will strengthen and make primary health centres (PHCs) effective all over the country.
  • Modicare aims to provide health cover to 100 million poor families.
  • The scheme will provide cost coverage up to Rs 5 lakh annually, to a poor family, for hospitalisation in an empanelled public or private hospital.
  • This will be done through a government-funded programme that merges central and state health insurance schemes.

A recent study puts Kerala, Punjab and Tamil Nadu on top in health indices but Tamil Nadu runs neck-to-neck with Kerala most years and sometimes does better in some parameters.

Tamil Nadu Achievements :- 

In Achieving World Goals set by different organisations :-

  • Tamil Nadu has already achieved the Millennium Development Goals set by the United Nations, fulfilling national targets far ahead of most other states.
  • It is racing towards achieving the UN’s Sustainable Development Goals, the deadline for which is 2030.
  • Tamil Nadu is also one of the best performing states in terms of implementing reproductive and child health schemes.
  • The current infant mortality rate in the state is 19 per 1,000 which is well below the national rate of 27 per 1,000.
  • It tops the country in bringing down maternal mortality rates (MMR). It was 62 per 1 lakh in 2015-16, according to state data whereas the current MMR rate in India is 167.
  • For the last 10 years, three out of five people in Tamil Nadu have been covered by medical insurance, which is tax-funded.

Tamil Nadu – Chief Minister Comprehensive Health Insurance Scheme :-

  • When Jayalalithaa came to power in 2011, the Chief Minister’s Comprehensive Health Insurance Scheme was introduced for providing treatment for 1,016 procedures, 23 important diagnostic procedures and 113 follow-up procedures, providing insurance cover of Rs 1 lakh per year and Rs 1.5 lakh for certain complicated procedures.
  • Complete cashless transactions were allowed up to the insured amount.
  • Smart cards have been issued to 1.58 crore families. In a state with a population of 7 crore, this is a large number.
  • The number of hospitals empanelled to provide treatment are 751. Until January 2017, 17.4 lakh people benefited under this scheme.
                   Current Situation :-
  • The sum insured for specialised procedures has been enhanced from Rs 1.5 lakh to Rs 2 lakh per annum, and 312 new procedures have been added to the scheme.
  • This also covers migrant workers who have lived in the state for more than six months and orphan children.

Tamil Nadu Increasing Budget Every Year :-

  • The state government has been substantially increasing the budget to the health sector every year—Rs 10,157.86 crore have been provided in the budget for 2017-18.

Public Health Centre :-

  • The state has 1,747 PHCs, and each centre covers 20,000 to 30,000 people, depending on the location.
  • There are 336 urban PHCs and Chennai alone has 140 PHCs working under Chennai Corporation.
  • PHCs are being upgraded in each block (one per block) to provide round-the-block essential services, and each one is provided with an operation theatre, diagnostic equipment and an ambulance.

Health Sub Centre :-

  • Health sub-centres (HSC) have been established for population of 3,000 in the plains and 2,000 in hilly areas.
  • There are 8,700 HSCs in Tamil Nadu providing outreach services. Village nurses are based in HSCs.
  • These are the hub for providing maternal and child healthcare and family welfare services to the rural areas.
Bigger Question is :-

Will Modicare be using successful state models which have a record of sustained investment in education, hygiene and primary healthcare achieve high scores in health indices ? & If Centre wants to cover masses then they surely have to look on the successful State in implementing Health Schemes. Centre should collaborate with states. 

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