Ayushman Bharat 2.0
What does the second term of Modi mean for Ayushman Bharat? A HE Report.
The landslide mandate of 2019 Lok Sabha polls shows that flagship schemes of the NDA government helped BJP to emerge triumphantly.
That's precisely what, on the evening of May 23, Prime Minister Narendra Modi's victory speech mentioned in his speech. His victory, he said, was not his, but that of the beemar vyakti (ailing citizen), who was unable to afford treatment for several years, and has been able to do so under his [Modi's] regime. The focus here is the Centre's health insurance scheme, PMJAY.
The scheme offered something to the majority of the electorate. Thirty-three out of 36 states and Union Territories of India have signed MoUs with the National Health Authority (NHA).
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Even the states ruled by the opposition parties are part of the national scheme. The Centre and states share the expenses in the 60:40 ratio in general category states and 90:10 in the case of North Eastern states and the three Himalayan states of Himachal Pradesh, Uttarakhand and Jammu & Kashmir.
Before 2014, towards the end of the UPA regime, there was a consensus that there was policy paralysis in India. Clearly, there is no indecisiveness in policy-making now.
The scheme has a dedicated agency NHA for implementing the project. The size of the programme and the potential volumes involved also helps NHA negotiate a pricing system that is the lowest possible. Just take a look at the amount of money the government has spent in the last six months? The government has spent around Rs 2600 crores, during the previous six months. On top of it, the rates are 50 percent lower than the market rates.
According to the Union health ministry, more than 17,000 centres are operational, and in the coming year (2019-2020), the department will be looking at upgrading an additional 25,000 centres.
There were several positive stories like that of Septuagenarian Kallu Kamath from Madhubani who became the first person from Bihar to get corneal transplant under Ayushman Bharat scheme. The operation was done at Patna Medical College.
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The National Health Authority (NHA) and the National Cancer Grid (NCG) have already signed a Memorandum of Understanding to develop uniform standards of patient care to battle cancer under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB - PMJAY). NCG is an initiative of the Indian Government to create a network of cancer centres, research institutes, patient groups and charitable institutions across India.
So, did the healthcare reforms help BJP win the second term?
The battle for India clearly was clearly about healthcare issues too. In fact, a survey about voters needs, carried out by the Association for Democratic Reforms, showed that health centres and hospitals were the second most important issue, after jobs.
Public healthcare is necessary because it is a basic necessity which should be available to every citizen in the country, regardless of their social and economic status. Moreover, over the last five years, healthcare has featured prominently in the BJP's policy and legislation. In India, nearly 20 percent of health sub-centres and 4 percent Primary Health Centres were without running water as on March 2017, according to Rural Health Stats of 2018.
The Bharatiya Janata Party (BJP) has already promised the effective implementation of an even more beefed up version of its already ambitious flagship initiative — the Ayushman Bharat.
There is a belief in the message and messenger, but what could be the new priorities of the government? National Medical Council Bill will be part of the agenda. The government couldn't pass the law, due to protests from sections of doctors from the Indian Medical Association.
BJP had a satisfactory majority in the Lok Sabha but lacked numbers in the upper house, the Rajya Sabha last time. For any Bill to clear Parliament, it has to pass both houses of Parliament and then assented by the President. Before the Bills are being passed, a debate is held where MPs highlight specific issues they might have with the legislation and how they might be corrected. They put in amendments to make changes in the law too. The system is designed so that one house acts as a counter-balance to the other, especially in the case of a majority government, and ensures that bad laws do not get through. For the new government Medical Council Bill would be high on its agenda.
India has embarked on a significant rehauling of its healthcare system. The country has implemented renovation and expansion of old medical colleges and conversion of public health centres to wellness centres. Moreover, healthcare will be the next engine of growth and job creation for the Indian economy. In fact, to make healthcare cheaper, the Modi government is said to have a plan ready to open thousands of pathology labs for affordable, reliable, blood tests.
While the sheer size of beneficiaries is heartening, and the penetration is still a long way to go; it is time the debate on Ayushman Bharat discussed the other issues related to the healthcare sector too.There are several issues which need immediate attention.The same attention should be given to issues like limited seats in medical colleges.There are several collective, historical and political factors for this. However, there is one reason. There is almost no growth in the number of undergraduate and postgraduate seats in government medical colleges. Due to the sheer size of the population, stringent requirements of infrastructure, staff, patients, qualification of teaching staff from medical education should be changed. More doctors, cheaper healthcare through medical colleges at every district, spending money on treatments that work in real life are some of the areas that need immediate attention.
And now that the government is back with a bigger mandate, it should implement crucial laws like Nation Medical Council Bill.