BJP's Delhi healthcare challenge: Enrol over 6 lakh families, raise health capex

The new government in Delhi would need to solve for more than Ayushman

The new BJP government in Delhi will have a gargantuan task of enrolling over 6 lakh families in the Ayushman Bharat scheme. But more difficult would be to raise the health capex spending on par with other states.

The BJP, in the run-up to the elections, promised to implement the central government’s flagship health scheme in Delhi, besides providing an additional cover of Rs 5 lakh for poor families in the state.

The 2011 Socio Economic Caste Census pegged the number of poor families in the national capital at around 6 lakh.

“In our first cabinet meeting, we will implement the central government’s Ayushman Bharat Yojana, to provide free treatment up to Rs 5 lakh and the state government will provide Rs 5 lakh additional cover for all the poor families,” the party had stated in its manifesto.

It also plans to provide additional health cover and OPD services to senior citizens in the national capital.

The administration also plans to merge the Delhi Aarogya Kosh scheme with the Ayushman Bharat scheme, which provided healthcare to the poor.

DAK had provided treatment for over 100,000 people until October 2024 and had covered 130,000 in 2022-23.

NFHS-5 data shows that just 25 percent of the households in the national capital had one member covered under a health insurance scheme, while the corresponding ratio for Chandigarh was 32 percent. Tamil Nadu had a coverage of 67 percent, while poorer states like Madhya Pradesh and Jharkhand also had more coverage than Delhi.

Health spending lags

A Moneycontrol analysis shows that despite Delhi outspending most other states as a percent of total Budget spending, the national capital lagged when it came to spending as a proportion of its Gross State Domestic Product.

While Delhi spent 12.7 percent of its Budget on health in 2023-24, more than double the national average at 5.5 percent and higher than likes of Goa at 8.9 percent, as a proportion of GSDP the spending had remained constant over the last decade.

In 2023-24, the national capital spent just 0.7 percent of GSDP on medical and public health, lower than Kerala’s 0.72 percent and 1.5 percent for Goa.

Madhya Pradesh, which had higher coverage than Delhi, spent 1.1 percent of GSDP on health.

Capex lags further

The track record was worse on medical and public health capex. While Delhi spent 0.2 percent of the entire Budget on medical capex, Kerala spent 0.28 percent.

Tamil Nadu had even more spending as the southern state spent 0.6 percent of the total Budget on medical and health capex.

Delhi lagged behind Gujarat and Goa on capex spend as well.

Health capex had  declined in the national capital, while it was ranked fourth in the country in undertaking health capex in 2013-14, a decade later it was ranked ninth.