Indian Prime Minister Narendra Modi launched the Prime Minister Jan Arogya Yojana- Ayushman Bharat on Sunday (23-09-2018). On this occasion, the PM said that the scheme was a step towards serving the country’s poor people and that it would come into effect from Sunday. “Some call it Modicare; some call it a scheme for the poor. It is definitely a scheme to serve the poor,” he said.
It is very early to say how much the benefits of the world’s largest health insurance scheme will be available to the poor, but the benefits of the previous health plans have reached the poorest of the people in the pulse. Yes, private hospitals and insurance companies have made a lot of money.
In the budget session of 2018, Finance Minister Arun Jaitley announced the Ayushman Bharat scheme. The objective of this scheme is to provide health insurance to economically weaker people (BPL holders). It will provide cashless health insurance of up to Rs.5 lakh to each family coming under it.
Two health plans already being implemented in this scheme – National Health Insurance Scheme and Senior Citizen Health Insurance Scheme – will be merged into Ayushman Bharat. According to the plan, 40% of the population of the country will be brought under insurance coverage.
In spite of millions of claims, the truth is that the National Health Insurance Scheme has not been successful in providing financial protection to the poor. If we see the analysis, only private hospitals and insurance companies can get benefit directly and indirectly.
Under the National Health Insurance Scheme implemented in 2008, only about three and a half million out of six million households were covered. Nearly 30% of the claims were made out of the sale. The company’s earnings were better as the premium amount.
Why is the poor man afraid of going to a private hospital? Because the poor cannot afford the hospital’s expensive treatment. The poor have serious and sometimes incurable diseases, and it seems to be better to force them to go to an expensive or well-equipped hospital for treatment, to avoid miserable condition of government hospitals. But some government hospitals are in great condition. The names of select government institutions like Delhi’s AIIMS are famous due to their quality and better functioning.
Primary health services should be made so much better and widespread that poor people get themselves treated in government dispensaries and centres only. To provide insurance based healthcare, there should be provision for both indoor and outdoor facilities, as well as filling the premium to free the poor public.
Unless government hospitals provide better facilities, the Ayushman Bharat scheme will not provide relief to the poor. This is possible only when some important and practical points will be taken into consideration in the scheme. The scale of treatment given under the scheme should be fixed. The quality should be closely watched. The hospitals which are listed under the scheme should monitor the quality of the hospitals and the distribution of the drug.
If expensive branded medicines and equipment are being used, then it will also be noted that this is not unnecessary. Strict action should be taken against hospitals refusing to recruit patients. The health facility available under the Ayushman Bharat scheme should be affordable and practical so that it is easy to treat general public.
There are hospitals and insurance companies in the plan, which have been contracted for the treatment of the poor. According to the rules and provisions, accountability has been set to provide better treatment to them at all times. But what happens in a situation where poor patients are trapped in the vicious cycle of expensive treatment and expensive medicines – the benefit is ultimately to private hospitals and insurance companies.
Suppose a poor person has to have a kidney transplant, will he be transplanted only within those five lakh rupees? If the transplant is done, then what about the expenditure after transplantation? Rather than insuring, if the government attempts to provide medical facilities in the government hospital, then arguably the benefit will go to the general public. I think the insurance scheme is a temptation only in which the poor will remain trapped.
The Ayushman Bharat scheme is arguably for the benefit of the poor, but it would be wrong to believe that medical professionals and insurance companies will not take advantage of this scheme for earning in the era of market economy.
Yes, if people benefiting from this scheme and every pillar of the institution providing the facility will play its own responsibility honestly, then Ayushman Bharat will definitely prove to be “Ayushman Bhav”.