The Ayushman Bharat scheme has two parts – the National Health Protection Scheme (NHPS) and Health and Wellness Centers (HWC). The fund allocated to both these schemes are grossly inadequate.
The Finance Minister Arun Jaitley referred to NHPS as the “World’s Largest Government funded healthcare scheme”, yet only ₹2000 crore were allocated to it. NHPS plans to provide a health cover of ₹5 lakh to 50 crore families per year. The allocation of ₹2000 crore by the centre would mean an amount of ₹40 per person a year. Even the later projected ₹11,000 crore is less for the scheme of this size.
Under HWC, 1.5 lakh healthcare centres are to be made across India to provide comprehensive health care. The fund of ₹1200 crore, committed to this project, can only construct ten thousand such centres.
Our country’s primary health care has been focusing on reproductive health, newborn and children health, as well as controlling priority communicable diseases. But NPHS would include aims to cover other non-communicable diseases, mental health, care of elderly, dental health, etc. Although it would not cover preventive, promotive and out-patient care. So, it is unlikely to lead to a larger public health benefits.
NPHS is not a new scheme, it was announced in the 2016 budget. The only difference being that the sum assumed until now was ₹1 lakh which has been increased. The scheme has been a non-starter since two years. The 2018 version plans to build on Rashtriya Swasthya Bima Yojana (RSBY) but does not address problems related to it. Reviews show that RSBY has not reduced health care costs for the poor, with many states discontinuing it.
NHPS also overlaps with various state health insurance schemes. Its funding has a 60-40% share between the centre and state. The states are unwilling to bear this cost if they already have such insurance schemes in place.
Given all this, ‘Ayushman Bharat’ with its promise to cover ₹5 lakh family might become another tactic to win the 2019 general elections.