A lot of countries in the world have free health care. It means that their citizens can avail of basic medical treatments without any cost. The scope and coverage provided under the free universal health care depends from country to country.
India ranks 144 out of 201 countries in the STC Health Index. It is a really depressing number irrespective of whichever metric you focus on. According to the United Nations Development Program (UNDP)‘s Human Development Report of 2016, India’s rank was 131 out of 188 countries which were ranked. Gujarat ranks 5th in the country in terms of per capita income but 10th in terms of HDI. 
A lot of countries which are in the top quartile of both these indexes have free and universal health care. The scope of this universal health care differs from country to country but all of them have a really strong health care system for the poorest of its citizens.
A large part of Indian population is uninsured and does not have access to quality health care. A serious illness can push the family into the trap of debt and in some situation, lead to death. A lot of government schemes usually cover only basic illness and no critical illnesses.
Mukhyamantri Amrutum (MA) Yojana
Under the Mukhyamantri Amrutum Yojana, any person, whose family income is Rs 1.5 lakh per annum or less, can avail cashless medical and surgical treatment for catastrophic illnesses related to:
- Cardiovascular diseases
- Renal (Kidney) diseases
- Neurological diseases
- Cancer (Malignancies)
- Neo-natal (newborn) diseases
To understand the details about the scheme, we would like to introduce you to two of our friends, Inquisitive Ishan and Intelligent Imran!
Ishan is 15 years old and loves to learn new things. He learns by asking questions. He shares all that he learns with his parents and friends. He usually asks his questions to the local government employee, Imran.
Ishan: Hello, I would like to know more about the Mujhyamantri Amrutum Yojana that the Government of Gujarat has started. I read a little in the newspaper and I know a little about it. I still have a few doubts.
Imran: Sure Ishan. I would love to tell you more about it.
Ishan: How many procedures does the scheme cover in total?
Imran: The scheme covers a total of 628 pre defined procedures. It also covers the follow ups on those procedures.
Ishan: That’s great. Will the government cover all the costs without any limit or is there a limit?
Imran: The government assures a sum of upto Rs. 2,00,000 per family per annum. The scheme also guarantees Rs 300 as transportation charges for every instance of availing treatment from the hospital. 
Ishan: Wow. That’s a significant amount of money. What all do I need to avail this opportunity?
Imran: You just need to get a ‘MA Vatsalya’ card. It has has a QR code, photograph of the head of the family, a unique registration number and other details of the family members. To get the card, a family member needs to get income certificate from their district/taluka officer or collector, a proof of residence (ration card), a identification proof, and a Below Poverty Line Certificate.
Ishan: What do I have to do once I have all these four documents?
Imran: It is really simple after that. You just have to take these documents and go to the Taluka Kiosks or Civic Center Kiosks. These places will have equipment which will collect your fingerprints and photograph. The people working there will print the MA card for you and give it to you in a plastic bag. They will also provide you with a pamphlet which will tell you the benefits of this scheme and which hospitals are covered under it.
Ishan: What if my card is damaged or lost? What do I do in that case?
Imran: You don’t have to worry. You just need to go to the Taluka or City Civic Center and ask for a copy of your card.
Ishan: If I go to one of the hospitals on our list, do I need to pay them anything? What if they don’t have medicines which are needed?
Imran: You don’t have to pay any amount. The scheme covers everything from consultation to medicines. It is the responsibility of the hospital to get the medicines which are required.
Ishan: Do these hospitals get paid by the state government? How much do they get paid?
Imran: Yes the government has pre-decided ‘package’ rates for the procedures and it pays the hospital that rate for every procedure conducted. The details of that ‘package rates’ can be found here. In order to encourage private accredited hospitals, government has decided to provide them with 10% more than the prescribed ‘package’ rate. A district wise list of network hospitals under this scheme can be found here.
Ishan: What if a hospital or someone at the hospital refuses to treat the patient or asks for payment?
Imran: In that case, you should immediately call the toll free number 1800-233-1022 or find the Arogya Mitra in the hospital.
Ishan: Thank you Imran for explaining this to me so well. I will definitely tell more people about this scheme so that more people can benefit from it.
MA Yojana has earned a lot of praise for the scale and scope of its impact. According to the website, more than 50 lakh people in the state already have MA Cards.
The size and aspirations of the scheme lead us to a big question:
Can and should this be scaled up to cover the entire population irrespective of income?
Free universal healthcare is a slippery slope. Once people start seeing its benefits, more groups will want to be covered under the scheme. Currently it is funded entirely by the State government and if the number goes up, it will feel the economic pinch sooner rather than later.
Isn’t it the government’s duty to provide basic care to all its citizen, especially the ones who are at risk? Should the government promise to pay if it doesn’t know where it will get the revenue to fund such a scheme? Once we provide free universal health care, where do we stop? Do we also provide free universal food security? Do we also provide free basic minimum income?
In the short term, the MA Yojana is definitely a big step towards improving falling health standards in the state. If implemented effectively, it can massively benefit the most at risk strata of the state. In the long run, it raises a lot of tricky but interesting questions.