Healthcare programmes should be structured appropriately: US official

As India embarks on a massive healthcare programme, a top US official behind the rejuvenated healthcare system of the Trump administration feels if not structured appropriately, it can take a growing amount of the national budget.

Seema Verma, 48, Administrator of the Centers for Medicare and Medicaid Services, serving in the Trump administration, also said such programmes should be designed to promote competition.

“I’m always careful not to comment on other countries efforts. I think every country has their own set of unique challenges. What I will say from my own experience, looking at the programmes that the United States has, one of the things that I have learned over time is that creating an open-ended entitlement programme can have a very significant impact on the entire government,” Verma told PTI.

Open-ended entitlement means that as long as a state is willing to spend more state funds to pay for qualified benefits for eligible recipients, the federal government is obliged to match the states expenditures at the states matching rate. Right now, various entitlement programmes in the US, its safety net programmes, medicaid and medicare programme, which provides care to the most vulnerable people, older adults, are now almost a third of Americas federal budget, she said. And it is the number one or number two budget items, she added.

Verma was responding to a question on India’s new healthcare policy Ayushman Bharat which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage upto ₹5 lakh per family per year for secondary and tertiary care hospitalisation. So over time, she said, if not structured appropriately, it can really take a growing amount of the budget.

“So I think these programmes that are designed to help people should be designed in a way that promotes competition so that you have providers competing on cost and on quality and its not open ended so that people know theres a defined budget, theres defined growth rate, and that people are making decisions and not the government,” Verma said.

Responding to a question, the top Indian-American official said she is always open to having conversation and sharing her experience on healthcare. Creating an open-ended entitlement has significant problems. The US is having trouble affording and supporting those programmes, she said. Such programmes, she reiterated, have to be designed with a defined growth rate.

“There should be a way that promotes competition. The government setting prices and those kinds of things doesnt create innovation in the system. You want to make sure that our providers are competing for patients on the basis of cost and on quality,” Verma said. One of the highest-ranking Indian-Americans in the Trump administration, Verma was born in the United States. Her parents migrated to the US from Punjab. Her husband, also a physician, has his origins from Patna, Bihar.