India’s decision to expand its healthcare programme, providing free medical insurance coverage to citizens aged 70 and above, is a landmark move that demonstrates the government’s continuing commitment to social welfare. This extension of healthcare benefits comes at a time when the country’s ageing population is growing, bringing to the fore concerns about the ability of the elderly to access quality medical care. The expansion promises to provide an annual coverage of Rs 5 lakh per family.

This initiative is expected to positively impact an additional 60 million people. India’s healthcare system, despite these improvements, continues to face significant challenges, particularly in terms of infrastructure and resources. The new scheme is an extension of a healthcare programme launched in 2018 that covers over 500 million citizens, largely targeting poorer families. The promise of Rs 5 lakh in coverage per family is undoubtedly impressive, particularly as healthcare costs for the elderly can quickly escalate. For individuals over 70, who are more vulnerable to chronic illnesses and require regular medical attention, this financial cushion can offer some peace of mind. However, while the initiative is ambitious in scale, it raises several critical questions about the efficacy of its implementation.

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Public healthcare in India has been historically underfunded, with government spending on healthcare consistently below 2 per cent of GDP over the past decade. This places India among the countries with the lowest healthcare spending globally. Expanding coverage is one thing, but ensuring that the infrastructure can support the demand is another challenge altogether. India suffers from a shortage of hospitals, trained doctors, and healthcare professionals. In rural areas, where the majority of the elderly population resides, access to quality healthcare facilities is often limited. Expanding the insurance coverage to citizens will do little good if they cannot access timely and effective treatment. Additionally, as healthcare inflation continues to rise, the value of Rs 5 lakh might not suffice to cover extensive treatment for serious illnesses.

Medical treatments, especially for ailments such as cancer, heart disease, and organ transplants, can easily surpass this amount, even in government hospitals. The challenge for the government will be to manage the growing expectations and the actual utility of the programme in a landscape where out-ofpocket expenditure on healthcare remains high. While this expansion is undoubtedly a step in the right direction, it should be viewed as part of a larger reform process. India needs to significantly ramp up its investment in public health infrastructure to ensure that the benefits of such insurance programmes reach every corner of the country.

Addressing the gaps in healthcare facilities, particularly in underserved areas, and increasing the availability of trained healthcare workers must be prioritised. This expanded insurance coverage is an important move, but it must be accompanied by systemic changes that strengthen India’s healthcare system as a whole. Only then can the country truly provide comprehensive and accessible healthcare to its elderly population.