On the front of healthcare reforms, India has not done much since independence. In this regard, PM-JAY or Ayushman Bharat is one of the biggest healthcare reforms in the world. The policy aims to cater to the healthcare needs of the poor population has been a stupendous success and has been lauded by many including the international institutions and personalities.
Despite the success of Ayushman Bharat, the Opposition has been active in maligning the scheme. Some opposition ruled states have in fact either refused to implement it or have pulled out of the scheme offering flimsy excuses to deprive their constituents of quality healthcare. To counter the propaganda against the Ayushman Bharat, to outline its objectives and to celebrate its achievements, Defence Minister Nirmala Sitharaman recently published a facebook note.
In the note, Defence Minister describes the various facets of the Ayushman scheme and how it has already succeeded in its primary goal. She also remarks on the ease with which Ayushman Bharat has been implemented.
On the Ayushman Bharat, Minister Nirmala Sitharaman writes:
“Most of us have grown up watching movies with the storyline revolving around an old father battling terminal illness, a teary eyed mother frustrated by the cost of medical expenditure and a son(the hero) struggling to make ends meet. While the situation has improved over the years, propelled primarily by the coupling effect of the decreasing cost of medical facilities and increasing penetration of insurance services, a majority of Indian households continue to incur heavy out of pocket health expenditure. Even after seven decades of Independence, the desire for a seamless and affordable health insurance scheme remained elusive to a large section of Indian population.
Ayushman Bharat encapsulates a progression towards preventive, curative, palliative and rehabilitative aspects of Universal Healthcare through access of Health and Wellness Centers (HWCs) at the primary level .It envisages provisioning of financial protection for accessing curative care at the secondary and tertiary levels through engagement with both public and private sector.
Ayushman Bharat does not come with a tag of “it is a good scheme but will take time to show results” . It has already achieved a paradigm shift in healthcare within 3 months of its launch and has managed to provide succour to the poorest of the poor and the middle class. More than 8 lakh beneficiaries have been admitted to empanelled hospitals and claims worth Rs 662 Cr have been settled. Within 100 days of its launch, it has been lauded by organisations like WHO and independent philanthropists like Bill Gates. India’s health sector is amongst the largest and fastest growing sectors and is expected to reach 280 Billion USD by 2020. Once fully implemented, PM-JAY will thus become world’s largest fully government-financed health protection scheme. In this context, it is very unfortunate that some states have chosen to opt out of the scheme for reasons of political expediency.
Pradhanmantri Jan Aarogya Yojana (PMJAY) plans to cover over 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries) according to the socio- economic caste census( SECC). It provides a cover of upto Rs 5 lakhs per family per year which includes 1400 pre-defined packages spread over 23 specialities that standardize the entire process.
Ayushman Bharat subsumes the erstwhile Rashtriya Swasthya Bima Yojana (RSBY) launched by the previous government in the year 2008, which provided an annual insurance of Rs 30,000 per family. PMJAY scheme has made some major improvements aimed at ease of living for the common man. There is no cap on family size, age or gender and covers pre- existing diseases and has a complete cashless, paperless access. It covers Maternal and child health services ,non-communicable diseases, including free essential drugs and diagnostic services.
Personalized beneficiary identification letters signed by the Hon’ble Prime Minister with family card are being sent to all the identified families in the villages and towns across the country. So far more than 7.5 crore letters have been dispatched and are on their way to the beneficiaries’ doorsteps. The same was achieved by the robust IT systems and by preparing teams which were then deployed phase wise so that states can move smoothly towards the implementation of the scheme. Robust IT systems have also been deployed in Hospital empanelment module and Hospital Transaction Management system to ensure transparency and ease of operations.
Before the launch of Ayushman Bharat, around 62.58% of our population had to pay for their own health and hospitalization expenses and were not covered by any form of health protection. Each year 4.6% of the population is pushed below the poverty line as people meet their healthcare needs spending large proportion of their income and savings, borrowing money or selling their assets. PM-JAY will reduce catastrophic expenditure for hospitalization which will help in mitigating the financial risk so that every citizen can access the quality health services without facing financial hardships.
Ayushman Bharat is a part of a series of reforms carried out by the Modi Government like the Jan Aushadhi Scheme, reduction in the prices of cardiac stents and knee implants, to fulfil the vision of Health for All and Universal Health Coverage.”