No radical change in national health policy

The 2017 national health policy document continues to be an extension of the previous two such policies (1983 and 2002)

oming after 15 years of the last such policy document, the National Health Policy (NHP) 2017 had raised many expectations. Given that this is the Narendra Modi government’s first such policy statement on health, many experts also hoped that it would announce a radical shift in the government’s approach towards healthcare. However, no such radical shift came about, and in many ways NHP 2017 continues to be an extension of the previous two such policies (1983 and 2002). NHP 2002 also spoke about “enhanced healthcare spending” and “restructuring of the national public health initiatives” to achieve more “equitable access” to healthcare. It is interesting to note that the stress in the 2017 document continues to be on these very aspects. In fact, NHP 2017 also dropped the proposal of making health a fundamental right.

Having said that, there are some positive moves. This is perhaps the first time such a national policy document has recognized the shifting epidemiology of diseases, and put special focus on lifestyle diseases such as cardiovascular disease, cancer, diabetes, along with communicable diseases. Another notable announcement is the intent to make primary healthcare services more comprehensive and widen their net. Only time will tell if the policy document is implemented in spirit on the ground or whether we will read a recap of these noble intents in another document 15 years down the line.

Meanwhile, let’s take a look at some of the positives and the disappointments of NHP 2017.

Despite several years of strong economic growth, government spending on healthcare in India has only managed to touch 1.15% of gross domestic product (GDP). Compared to this, India spends around 2.4% of its GDP on defence.

Global evidence on health spending shows that unless a country spends at least 5-6% of its GDP on health, with government expenditure being a major part, basic healthcare needs are seldom met. NHP 2002 had underlined the government’s intent to increase public expenditure on healthcare to 2-3% of GDP. NHP 2017 again lays down a modest target of reaching public health expenditure of 2.5% of GDP by 2025. The policy document also targets bringing about an increase in the use of public health facilities by 50% from current levels by 2025 and making two beds available per 1,000 population. At a health expenditure of 2.5% of GDP, these targets look unrealistic and unachievable, not to talk about the goal of universal healthcare. If a sustained economic growth doesn’t bring about basic healthcare and living benefits for millions, it indicates a country is clocking empty growth, without significant development. A target of at least 3% of GDP by 2025 would have been welcome.

NHP 2017 envisages widening the net of basic healthcare services delivered through primary healthcare. It proposes moving from a very selective to a comprehensive primary healthcare package which includes geriatric healthcare, palliative care and rehabilitative care services. The policy advocates allocating a major proportion (up to two-thirds or more) of resources to primary care, followed by secondary and tertiary care. It also aspires to provide at the district level most of the secondary care which is currently provided at a medical college hospital.

This shift in policy is a positive change as it takes a holistic view of the health problems being faced by all sections of people, including the rural populations which often depend on public healthcare facilities for all kinds of treatments. Widening the net of primary healthcare services will enable coverage of a larger section of people through these services, and reduce the burden on district hospitals. However, while pledging to allot a major chunk of resources to primary healthcare with a widened net is a welcome move, this should not mean that the government starts withdrawing from secondary and tertiary healthcare.

NHP 2017 makes repeated references to strategic partnerships, and this is the first time a policy document has so clearly recognized the role of the private sector in taking healthcare to all. NHP 2017 envisages private sector collaboration for strategic purchasing, capacity building, skill development programmes, awareness generation, and developing sustainable networks for communities to strengthen mental health services.

Instead of investing in setting up new hospitals, the government can enter into public private partnerships (PPPs) in every district and help private hospitals subsidize costs for people below the poverty line. This will take much less investment than opening new hospitals as it will utilize the existing infrastructure of hospitals. The goal of universal healthcare can be achieved faster and more comprehensively if the public and private sectors launch long-term partnerships with a vision to reach the last citizen.

By far the most notable change in the policy document is the recognition that India needs to turn attention to preventing the rising burden of lifestyle diseases. Apart from the unfinished agenda of addressing infectious diseases, nutritional deficiencies, the escalating epidemic of non-communicable diseases (NCDs) has become a major concern. NCDs contribute to 60% of the disease burden in India today. In this light, the clear guidelines on finding sustainable solutions to fight the growing burden of NCDs is a welcome approach.

Time for the states to do their bit

The Centre is helping to compensate for the states’ excesses, but it may not last long

ndia’s state finances have done an about-face. From 2009-13, state fiscal deficits contracted sharply but they have ballooned since. As a result, the spreads on state bonds (SDLs)—in effect the interest premium the states have to pay for borrowing—have skyrocketed. Today, India’s states account for 60% of overall government spending, thus more than the Centre. This means it is going to be increasingly important to understand the states, and state discipline is essential if the official recommendation that India’s public debt be lowered to 60% of GDP by 2023 (from 66% now) is to be met.

Over the last month, the states have released their budget documents. We have looked closely at those of 16 major states that make up about 85% of India’s economy and outline here what we believe is driving the excesses.

We find that the Centre’s revenue transfer to the states increased more than budgeted in FY17—from 6.5% of gross domestic product (GDP) revised estimate (RE) compared with 6.1% of budget estimate (BE). And there were changes in the composition. The proportion of “untied” funds, which the states can spend as they like, has risen vis-à-vis “tied” funds, where use is strictly defined.

Yet India’s states, on aggregate, overshot the fiscal deficit target (2.8% of GDP RE versus 2.6% of BE). The slippage was not about revenue. Luckily, all the shortfall from lower than expected stamp duty collections and oil value added tax (VAT) was made up for by higher transfers from the Centre. Instead, the entire slippage came from higher current spending (0.3% of GDP more than budgeted), while capex fell (0.1% of GDP less than budgeted).

Furthermore, we find that the states have not chosen to spend the “untied” funds wisely. The quality of state spending (proxied by the ratio of capital to current spending) has been gradually worsening over the past few years, even as the quality of the Centre’s spending (thanks to a lower subsidy bill and higher capex) has improved over the same time.

That was the past. For FY18, the states, on aggregate, have budgeted for a fiscal deficit of 2.6% of GDP. But we are not convinced by these estimates. A close look revealed that there are up to five different developments that the states may not have accounted for completely. Some of these threaten to worsen the aggregate state fiscal deficit, while others threaten to lower it.

Our analysis of the Central government’s budget shows that the Seventh Pay Commission wage proposal is expected to run up a bill of 0.6% of GDP. Experience shows that the states’ pay commission wage bill roughly equals the Centre’s. We estimate that so far the states have only budgeted for 0.4%, and the balance is likely to contribute to the slippage. Next, we estimate that the states have not fully accounted for the interest bill arising from the Uday (Ujwal DISCOM Assurance Yojana) bonds issued over the last two years (and to be issued next year). Finally, seven states will go into election mode over the next few years, and given past experience, could bump up expenditure in the run-up. These three things threaten to widen the deficit.

But there are offsetting factors as well. As the housing market stabilizes, stamp duty collections by states may rise more than budgeted. As oil prices begin to rise gradually, oil VAT revenue is likely to be higher than what the states are currently expecting. Considering everything, we find that the state deficit, on aggregate, could come in at an elevated 2.8% of GDP in FY18—the same as the revised estimate for FY17. And in this piece, we are not even incorporating the potential impact of farm loan waivers that Uttar Pradesh is likely to implement. There are risks of a wind of competitive populism spreading across states, endangering both national debt and deficit.

What does this mean for bond issuances, capex, the general government deficit and growth?

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Despite an elevated state deficit, we find reasons to breathe easy, at least for now. The consolidated public sector borrowing ratios are likely to fall in FY18, thanks to the Centre’s fiscal discipline, as well as estimates of lower Uday and public sector enterprise (PSE) bond issuances over the year (see chart). Overall borrowing is likely to grow at a lower clip than nominal GDP, which is a different way of saying that the supply of bonds will grow more slowly than their demand. It is fair to conclude here that the Centre is likely to compensate for the states’ excesses.

However, the Centre may not come to the states’ rescue ad infinitum. A simple regression suggests that SDL spreads are sensitive to overall borrowing and the SDLs’ share in that borrowing. If the states do not gradually lower their deficits over time, the benefits of falling Central borrowings can be easily offset by the rising share of SDLs. And higher spreads could keep the state interest bill elevated, even threatening to put states in a vicious cycle of high borrowings today leading to a high deficit tomorrow. In short, there is no getting away from lowering state deficits over time.

Thanks to the Centre’s continued discipline, the general government deficit is expected to inch lower over FY18 (from 7% of GDP to 6.7%). Our fiscal impulse model suggests a marginally negative impact on growth. We also estimate that the combined capex thrust of the state, Centre and PSEs (public sector enterprises) is budgeted to moderate over the next year. All this reinforces the view that economic growth over FY18 will be flat at best, lower than the V-shaped recovery that markets are expecting.

But there is a clear silver lining here. A lower general government deficit is good news for macro-stability, which, in turn, is critical during periods of global volatility, especially given that India is infamous for running a higher consolidated fiscal deficit and having a public debt ratio that is much higher than the emerging markets average. The Centre is making it come down for now. Will the states do their bit in the future?

IMD forecasts a normal monsoon, in boost to India’s rural economy

India Meteorological Department (IMD) in its first monsoon forecast says rainfall will be 96% of long-period average with a 38% probability of a near-normal season

India will receive normal rains during the June-to-September southwest monsoon season, the government’s weather office said on Tuesday.

If the forecast holds, it will boost rural demand and also alleviate rural distress, especially in states such as Karnataka and Tamil Nadu which are reeling under the impact of drought.

Rainfall will be 96% of the long-period average (LPA) with a 38% probability that monsoon will be near normal, said K.J. Ramesh, director general of India Meteorological Department (IMD). He added that rains would be evenly distributed across the country.

IMD will update these numbers in June.

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The average rainfall over the past 50 years, or the LPA, is 89cm. IMD’s forecast of 96% rainfall comes with a model error of 5%. It is considered to be above normal when it is between 105% and 110% of the LPA.

Till last year, IMD used to forecast probabilities for different rainfall scenarios such as deficit, below normal, above normal, normal and excess. However, for this year, the weather office gave the probability of only ‘near normal’ rainfall.

“The 38% probability is assigned to the normal category. This is also the highest among other rainfall scenarios,” said an IMD official who did not want to be named.

At a briefing, IMD’s Ramesh said the forecaster used both the static and the dynamic models of forecasting, but the dependence is more on the latter.

“The worries of an El Niño occurring during the peak of the southwest monsoon season are lower compared to it hitting at the end of the monsoon season,” said D.S. Pai, director of long range forecast at IMD, Pune.

El Niño is a weather phenomenon caused by unusual warming in the Pacific Ocean, resulting in atmospheric changes, potentially leading to a poor monsoon.

The onset of monsoon kick-starts the sowing season for summer crops in the country. India receives 70% of its annual rainfall during this period, which irrigates over half of its rain-fed lands.

In 2016, the monsoon was normal at 97% of the LPA after two straight years of deficit. The normal monsoon last year aided a rebound in agriculture growth to 4.2% (2016-17) after a dismal 1.2% growth and 0.2% contraction seen in 2015-16 and 2014-15, respectively.

Asteroid J025 of over 400 meters to pass close to Earth today, says Nasa

Nasa says asteroid J025 of over 400 meters wide will pass close to Earth today, zooming by at a distance of just over 1.8 million km, but with no chance of impac

An asteroid more than a quarter mile (400 meters) wide will pass close to Earth on Wednesday, zooming by at a distance of just over a million miles (1.8 million km), but with no chance of impact, according to Nasa scientists.

Smaller asteroids routinely make closer passes to Earth, but 2014 J025, discovered in May 2014, will be the largest asteroid to come this near to the planet since 2004, flying by at only about 4.6 times the distance from the Earth to the Moon, 1.1 million miles (1.8 million km).

“We know the time that the object is going to be closest within seconds, and the distance is known within hundreds of kilometres (miles),” Davide Farnocchia, a mathematician at Nasa’s Near-Earth Object programme, said by telephone on Tuesday.

Having several years of data on the asteroid’s trajectory gives scientists the ability to predict its path very confidently, he added.

The asteroid, estimated to be between one-quarter and three-quarters of a mile (600-1,400 meters) wide and twice as reflective as the Moon, won’t be visible to the naked eye, but sky watchers should be able to view it with home telescopes for one or two nights starting on Wednesday.

The approach of J025 will be the asteroid’s closest for at least the next 500 years.

In 2004, the 3.1-mile (5-km) wide asteroid Toutatis passed about four lunar distances, or just under a million miles (1.6 million km) from Earth.

Amateur astronomers may be watching J025’s journey, but Farnocchia said he and his colleagues have moved on to tracking even closer encounters, such as asteroid 1999 AN10, a half-mile (800-meter) wide rock predicted to pass only 236,000 miles (380,000 km) from Earth, or slightly less than the distance to the Moon, in 2027.

Getting a grip on Kashmiri alienation

The Indian Constitution still remains the best bet for a prosperous Kashmir. The problem today is not the lack of autonomy for Kashmir; it is much more sinister

Three recent events have brought the Kashmir Valley back into national focus. The first was the abysmal voter turnout in the Srinagar parliamentary by-poll. The second was a video of protesters abusing and assaulting jawans of the Central Reserve Police Force (CRPF) in Budgam district. The third was a video showing a Kashmiri tied to an Army jeep in order to prevent an attack from stone pelters in the same district. These three separate events have been used to build a larger narrative about the legitimacy of the Indian state in Kashmir.

This narrative is not entirely wrong, given that the biggest story among the three is undoubtedly the one on low voter turnout. The Indian state has long flaunted electoral participation as a validation of its claim of Indian democracy being in firm demand in the Valley. It is another matter that the claim was tenuous to begin with—the voter turnout in the 2014 Lok Sabha election in the same constituency was just 26%. Even by that standard, the fall to 7% last week was huge. The political scientist Pratap Bhanu Mehta wrote in The Indian Express: “…Kashmir has been lost on [Prime Minister Narendra] Modi’s watch.”

What changed between 2014 and 2017 that has made Mehta and several others arrive at this conclusion? One, the government in Jammu and Kashmir changed. And two, Burhan Wani, commander of the terrorist organization Hizbul Mujahideen, was killed in an encounter last summer. It is important to examine the moral legitimacy of these two changes and their potential to cause the massive alienation one is witnessing in Kashmir today.

In 2014, the verdict was split: The Bharatiya Janata Party (BJP) won the largest vote share (23.2%) and the second highest number of seats (25) largely on the back of its performance in the Jammu region. The Jammu and Kashmir Peoples Democratic Party (PDP) performed well in the Valley to emerge with the single largest number of seats (28) in the state. Such a fractured mandate, and the necessity of equitable representation of all regions of the state, compelled an alliance of opposites—the BJP, which is known for its nationalist plank, and the PDP, which pursues what is often called a “soft separatist” agenda.

The PDP was indeed a refuge for the alienated youth of the Valley who had continued to engage with electoral processes. The alliance with the BJP may have induced a sense of betrayal among its supporters. But the alienation in the Valley is remarkably self-centred: Its disavowal of the democratic mandate from the other part of the state is a case in point. Former Union minister P. Chidambaram once suggested that the mandate was grossly misinterpreted. He argued that either the BJP or the PDP should have formed the government and that the other should have occupied the opposition benches. In fact, Chidambaram’s interpretation is highly insensitive to the Jammu region, because he knows well enough that the Valley would never have accepted a BJP chief minister. But his interpretation is in line with the long trend of appeasement of the Valley at the cost of other regions in the state—not just Jammu but also Ladakh.

The second change since 2014—the killing of Wani—resulted in a prolonged season of stone pelting by Kashmiri youth. The response by the security forces, restrained as it was, ended up killing some and blinding (or partially blinding) some others, the latter because of the use of pellet guns as a riot-control weapon. This was exploited by many, including some human rights activists, to portray the Indian state as a brutal occupier. The growing Islamization of the anti-India protests and the fact that they occurred in reaction to the killing of a terrorist were conveniently sidestepped. The inability of the security forces to uphold the highest norms of morality in a conflict zone was overplayed, and it continues till today as the outrage over the Kashmiri man tied to the army jeep shows.

It is unfortunate that a few army veterans who should know the trade-offs of a conflict zone better have decided to give lessons in ethics to the current crop of officers, taking full advantage of the fact that their own tenures were completed in the era before the proliferation of camera-equipped mobile phones. It cannot be emphasized enough that barring a few isolated and condemnable incidents, the Indian forces have behaved admirably in Kashmir.

Those who advocate the need for a political healing touch for Kashmir often invoke former prime minister Atal Bihari Vajpayee’s slogan of “Kashmiriyat, insaaniyat, jamhooriyat” (Kashmir-ness, humanity, democracy). The Vajpayee government had pursued dialogue with the separatists under the ambit of insaaniyat, which was supposed to be more accommodating than the Indian Constitution. The process went nowhere because no matter how lofty the principle of insaaniyat sounds, relative to the Indian Constitution, it is rather nebulous. As far as jamhooriyat goes, it has lost at the hands of Islamic radicalization in the Valley. And Kashmiriyat still awaits the return of the Kashmiri Pandits who were driven away from the Valley in the 1990s.

The Indian Constitution still remains the best bet for an inclusive, prosperous Kashmir. The problem today is not the lack of autonomy for Kashmir; it is much more sinister.

What are the prospects of success of Indian democracy in Kashmir? 

Managing migration for equitable development

Labour migration is rising in India, but contrary to economic logic, inequality is still growing

It is no coincidence that in F. Scott Fitzgerald’s magnum opus on the American dream, The Great Gatsby, just about every major character is a migrant in 1920s New York—the narrator Nick Carraway is from Minnesota, his neighbour Jay Gatsby from North Dakota, Gatsby’s former girlfriend Daisy Buchanan is from Kentucky and her husband Tom from Chicago. Migration has been the cornerstone of the American way of life; people’s ability to pack up and move brought dynamism to the US economy, ensuring that the right people could be matched with the right jobs at the right price, thereby enhancing productivity and spurring economic growth.

However, this trend has been slowing for a while now. When the US Census Bureau began tracking migration in 1948, the annual mover rate was 20.2%. In 2016, it was down to an all-time low of 11.2%, according to data released last month. A Federal Reserve Board study published by Brookings Institution has similarly found that fluidity in the US labour market dropped by 10-15% since the 1980s. In short, working-age people are simply not moving like before.

There are several theories for why America is becoming a “nation of homebodies”: Nobel laureate Edmund Phelps argues that Americans are trapped in their own homes, especially after the 2008 crisis; David Schleicher at Yale Law School points to government policies which make it difficult for people to move across state lines. Others have pointed to the deteriorating quality of jobs (why move for a position that may become obsolete in a few years?) and the growing number of dual-income couples (it is harder for individuals to move if they must account for their partner’s job preferences). The bottom line is that with Americans not moving to where the better-paying jobs are, economic growth may take a hit. Already, inequality in the US is soaring and some argue it’s worse than in China.

In this context, the Indian labour market offers a fascinating study in contrast—here, labour migration is on the rise but inequality hasn’t dipped either. According to this year’s Economic Survey, Indians are increasingly on the move and in much larger numbers than previously estimated. Based on the 2011 census and railway passenger traffic, the 2017 survey employs a new methodology to find that annual interstate labour mobility averaged five-six million people between 2001 and 2011, and that the average annual flow of migrants was close to nine million, significantly higher than the 3.3 million deduced from previous census readings.

The new figures challenge conventional wisdom and lend themselves to an optimistic assessment of how integrated India’s labour and goods markets are—especially when one also factors in the survey’s high internal trade figures. Ideally, this free movement of goods and labour should have paved the way for lowering inequality within the country and bridging the gap between rich and poor states. This is what happened in China, for example, where poorer provinces have almost caught up with their richer counterparts. In India, however, the gap has grown along the north-south axis and the rural-urban divide.

An Organisation for Economic Co-operation and Development (OECD) study analysing growth, employment and inequality notes: “The benefits of growth have been concentrated in the already richer states, leaving the poorest and most populous states further behind (i.e Bihar, Madhya Pradesh, Uttar Pradesh...). In richer states, high growth rates have led to a boom in commercial and service sector activities, whereas in most of the poorest states agriculture is the main way of life... and industry is almost absent.”

The survey takes note of this problem and wonders “why greater internal integration has not led to a narrowing of income and consumption gaps across states”. It offers two possible explanations: First, “governance or institutional traps” have crippled convergence and, second, India’s reliance on “skill-intensive sectors rather than low-skilled ones” to fuel its economic growth has only accentuated pre-existing inequalities. Both lead to the dynamics of cooperative and competitive federalism, and raise the question: “Why isn’t there pressure on the less developed states to reform their governance in ways that would be competitively attractive?”

There are no easy or obvious answers but one thing is clear: While labour migration is a force of good, it has to be properly managed by the government to deliver the benefits in a just and equitable manner. In the poorer source states that see the most out-migration, it is imperative to improve education and health outcomes to deal with regional inequality. In the richer destination states, more so in urban megapolises like Delhi and Mumbai which are already bursting at the seams, the focus has to be on capacity augmentation. There is also the issue of individual migrant welfare—the government can start with making benefits and entitlements easily portable (as envisaged under Aadhaar), by ensuring a basic social security network for all migrants, and by allowing migrants easy access to affordable housing and homeownership.

These measures will also strengthen the forces of urbanization that are already under way and boost economic growth. Several studies have shown how urban economies are more productive than rural economies. Yet, in India, policymakers are still focused on reducing migration to the cities, as Pronab Sen noted in Mint earlier this month—and this is just one example of the many policy barriers to migration.

How should the government approach migration to spur economic growth?

Bhim: India’s ticket to a cashless economy

Converting the promise of the online payments app into digital dividends for India will require a concerted effort

The country seems to be on a train to cashless, and the Unified Payments Interface (UPI)—the payment system that allows mobile-enabled money transfer between bank accounts —seems to be the ticket to ride. While many banks have launched UPI apps, the Bharat Interface for Money (Bhim), the common app that can be used by anyone who has a bank account with a linked mobile number, is seen as the most promising. From the Prime Minister (PM) to district magistrates (DMs), everyone in government seems to be promoting Bhim—the PM invoking it in his Mann Ki Baat radio programme, and reportedly recently asking smartphone manufacturers to pre-install the app in phones; and DMs conducting “Digi-Dhan Melas” to push its adoption.

But can Bhim really be India’s ticket to a cashless economy? Our research with users (and potential users) of Bhim across four states in India suggests that it has a lot going for it, but ensuring mass adoption will require important product tweaks and a carefully executed go-to-market strategy to make the app go viral.

Bhim provides a smartphone front-end to make bank-to-bank payments. The beauty of the app lies in its simplicity—it’s “light” (2MB), has an uncluttered and simple user-interface (UI), and the transaction experience is fast. It also works on basic phones (*99#). Our research suggests that contrary to the perception of many payment apps, most users consider transactions on Bhim to be “safe” because it has government backing. And combining the superior user experience (UX) with UPI’s low transaction cost (currently free for both payers and payees), means that we finally have a payments app that can genuinely compete with cash on both convenience and price. This is especially attractive for small merchants, who need to do multiple quick small-ticket transactions and are wary of “going digital” given their razor-thin margins.

But scaling up will require more. On the product front, our research shows that less tech-savvy users struggle at different stages of the on-boarding process and are tripped up by the jargon (“passcode”, “UPI PIN”, “VPA”, etc.) There is a clear need for greater guidance and handholding through the on-boarding process, and in helping a user make the first transaction.

On the marketing front, a targeted go-to-market strategy is needed to convert the initial interest and impressive number of downloads (about 18 million) into active use. The secret sauce will be to get “network effects” (or the “WhatsApp effect”), i.e., people start using a platform because others in their network use it.

So what exactly needs to be done? There are five specific asks to ensure Bhim can scale.

First, make on-boarding simpler and guided: Given the challenges faced by less tech-savvy users in on-boarding, having a simple guided flow on each screen that walks users through the process, will help. Once a user has on-boarded, the home screen could provide a guided flow explaining how to transact, or the opportunity to do a first test transaction. A short video may be embedded in the app explaining key features, on-boarding, and first use.

Second, quickly launch incentive schemes. The finance minister in his budget speech announced two schemes for promoting Bhim—a referral scheme and a merchant cash-back scheme. We think these schemes have great potential if designed well. We recommend a simple design (for example, using the mobile number as the referral code) and including in-app notifications and nudges (for example, messages like “Congratulations, you have just earned Rs100, next goal: Rs500!”). The reward money should be transferred to the user’s bank account as soon as possible to capitalize on the “instant gratification” effect.

Third, drive behaviour change by targeting the right transactions. Payments is a classic “network effect” phenomenon. Research has shown that focusing efforts to drive transactions that are pervasive (affecting a large number of people) and repetitive (low-value, high-frequency) can lead to quick adoption. Our analysis of household spending in India narrows this to five transactions—payments at kirana stores, pharmacies, public distribution system outlets, public transport, and remittances. These five transactions account for about Rs22 trillion in annual spending (about 45% share of the household wallet) across approximately 100 billion transactions. Therefore, a concerted effort to drive these transactions by doing a concerted campaign to bring merchants such as kirana store owners, pharmacists, auto/taxi drivers on Bhim, for example, will be the holy grail to get scale. This can be done through targeted campaigns (mass-media, feet-on-street efforts, etc.) that narrowly focuses on these segments, with simple messaging around “Why Bhim” (key advantages), “How to use it” (step-by-step guidance) and “Why start now” (incentives offered).

Fourth, ensure Bhim is accepted in key payment networks, especially those backed by government entities. The Metals and Minerals Trading Corporation of India recently became the first public sector unit to accept payments through Bhim. A similar push is needed across other networks in the government’s ambit where many users transact daily: Petrol pumps, Indian Railways, city public transport systems, India Post, government hospitals, etc., should all become Bhim acceptors, quickly, for both online and offline transactions, and ideally offer a discount as compared to cash.

Fifth, nudge banks to promote Bhim uptake in its existing customer base. There are about 740 million debit cards in India but only about 18 million people have downloaded Bhim. Banks could be mandated to take steps to increase this penetration rate. This could be done through an SMS campaign for customers around Bhim and posters at each bank and ATM branch that detail the key benefits, essentials to get on-boarded, and the registration process.

Bhim holds great potential to help realize India’s vision of a cashless economy at the household level, and the building blocks are clearly in place. But well begun is (only) half done. Converting the digital promise of Bhim into a digital dividend for India will require a concerted effort.