The Top Moments from this Month That Reshaped PMJAY Discussion
The Top Moments from this Month That Reshaped PMJAY Discussion
A strategic lens is necessary to unpack issues and perspectives related to the Ayushman Bharat Scheme. In this article, HE looks at the scheme with accessibility, quality, patient-centricity along with challenges in the Indian Healthcare Industry.
Has Ayushman Bharat solved the issue of access and supply of healthcare in India? The Union Health Ministry thinks so.
The Union Health Ministry commended the Centre's health insurance project, Ayushman Bharat, in its end-of-year review. "So far 33 states and [union territories] are implementing the scheme,"stated the Ministry. "Treatment worth Rs 9,999.76 crore for 6,919,973 hospital admissions has been provided under the scheme. Sixty-eight thousand one hundred six cases of hospitalisations were availed outside the state of residence. Also, 19,839 hospitals have been empanelled under the scheme and 11.51 crore scheme cards, which include state cards, have been issued to the beneficiaries."
Here's an interactive map of the status of implementation of the scheme across various states:
Prime Minister Narendra Modi also hailed Ayushman Bharat recently. "Due to Ayushman Bharat, about seventy lakh poor people of India have been accorded free treatment," he said. "It is the world's largest healthcare scheme. The number of beneficiaries under this scheme is larger than the entire population of the US, Canada and Mexico."
Special Wards for AB Patients a Good Strategy?
According to news reports, specific wards and special treatment will be given to Ayushman Bharat-PMJAY recipients in government hospitals across all districts of Uttar Pradesh. Exclusive privileges will be provided to patients as per the administrative mandate of Principal Secretary (Health), Uttar Pradesh, State Health Authority (SHA) CEO Sangita Singh.
As per the order, Singh said that the government would provide treatment to Ayushman Bharat-PMJAY beneficiaries on a priority basis. For this, OPD slips will have a mention of whether the patient is a beneficiary or not. If feasible, separate lines, for Ayushman Bharat beneficiaries will be made accessible at these hospitals.
Internet Restored In Kashmir, Relief for AB patients?
The broadband internet service to all critical government-run hospitals in Srinagar and the borders was restored after remaining blocked for 147 days following the scrapping of Article 370 and bifurcation of J&K into two union territories by the Government of India on August 5. The patients, particularly those listed with different government schemes including Ayushman Bharat, had been encountering travails in availing benefits.
The attractiveness of Scheme for States
Delhi Chief Minister Arvind Kejriwal declared lately that many free healthcare projects have been offered by the AAP government to support people from all walks of life and revealed why he did not opt for Centre's Ayushman Bharat scheme.
Addressing a Townhall meeting in Delhi, Kejriwal stated the healthcare plans introduced by the Delhi government aids each citizen in receiving free therapy, medications and operation.
Kejriwal maintained that the Centre's scheme contains various stipulations which deter many people from receiving free treatment.
Arvind Kejriwal announced that the Centre came out with Ayushman Bharat scheme. But it specifies that those who have a motorcycle or car, mobile phone, fridge and those families who earn an income over Rs 10,000 will not get free treatment.
Odisha Proposes Changes in Ayushman Bharat scheme
With in the country, there is always a possibility for high performing states as well as low performers. States like Odisha have said that it had requested two modifications in the specifications of the Centre's Ayushman Bharat project before executing it in Orissa.
N K Das, Health and Family Welfare Minister announced that the state had already effected its own Biju Swaysthya Kalyan Yojana (BSKY), much before the Centre started the healthcare scheme. Das stated the state government had recommended the Centre not to make Aadhaar card compulsory for the patients attempting to access treatment at state hospitals.
IMA President Reprimands AB Scheme
Dr Santanu Sen, President of Indian Medical Association, also criticised the insurance-based model of PMJAY. "People of India want assured health policy and not insured health policy," the IMA president said, according to several news reports. "There are many hospitals in the country where patients have to buy even small things like syringes. Therefore, the government should bring a uniform, universal health policy instead of schemes like Ayushman Bharat so that health policies don't vary from state to state," he told reporters during a recent interview.
Private Hospitals Threaten to Stop Cashless Facility
There was also another recent announcement that could disrupt the healthcare industry. Private hospitals across the country have warned to end cashless facility under the scheme from February 1, as the government haven't paid ₹1,200 crores for treatment of patients under the Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS),
If realised, it will affect approximately 36 lakh, Central government workers, including their relatives, and pensioners under CGHS and above 52 lakh ex-servicemen and wards covered under ECHS in 1,000 empanelled hospitals and nursing homes in 71 cities. According to The Hindu, of these, over 1.23 lakh recipients are from Bengaluru.
4.5 Crore Fine for Erring Hospitals?
To understand the nitty-gritty of the PMJAY scheme, let's also take you through some of the challenges.
Under the Ayushman Bharat Health Insurance Scheme, 171 hospitals have been eliminated from the panel on charges of fabrication and a fine of over Rs 4.5 crore has been imposed on the hospitals. The National Health Authority announced this recently. According to the data acquired, FIRs have been filed towards six hospitals in Uttarakhand and Jharkhand.
A report stated that hospitals have already been barred from the panel. Hospitals concerned in misconduct have been fined higher than Rs 4.5 crore. National Anti-Fraud Unit of the National Health Authority has identified false e-cards based on algorithms produced internally by it and shared with States for due diligence and action.
Challenges Starting Point of Innovation?
Challenges are usually the starting point of Innovation. Healthcare is an unmet need in India. Government has to start somewhere. And the government doesn't have unlimited resources. The government should build resources and capabilities to nullify the risks. And responses from the state is almost like a checklist response. The insurance-based model has already been tried in other countries. Like Air Deccan, introduced low-cost airlines in India, when it was already a successful model in other countries. However, context is what makes whether something is a novelty or not. Sometimes, the elements might not be new, but how they put different features together that makes a difference. The most critical feature for judging a policy should be utility. Existing schemes didn't adequately solve the current problem of access to healthcare. That's why the government had come up with a new project. However, the government needs to experiment more with the idea to refine it.