Ayushman Bharat, the Pradhan Mantri Jan Arogya Yojna (PMJAY), is Prime Minister Narendra Modi’s signature medical insurance scheme. It is reportedly set to be rolled out across the nation on September 23, two days ahead of the birth anniversary of Rashtriya Swayamsewak Sangh (RSS) ideologue Pandit Deen Dayal Upadhayaya.
With this national health protection scheme, the Modi Government aims to cover over 100 million poor and vulnerable families (approximately 50 crore beneficiaries). It will be done by providing an annual coverage of up to 5 lakh rupees per family for secondary and tertiary care hospitalisation. It will subsume the ongoing centrally sponsored schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
Though India’s health indicators have made some improvements over the last decade, it is still lagging when compared to other countries similar to it in progress and per capita Gross Domestic Product (GDP). Indian Government expenditure on healthcare is a little over 1% of GDP today. In contrast, the world average healthcare outlay stands at 5.99%. Cross-country comparable NHA (National Health Accounts) data shows that India’s OOP (out of pocket) spending as a proportion of total health expenditure is extremely high when compared with BRICS nations. International experience indicates that low public spending is behind the high OOP share in India. Of the total health spending in India, the government contributes just 29%. Apart from financial neglect, the quality of public health services is another serious problem. The average middle-income Indian has shifted to private centres, thereby, increasing the average out-of-pocket health expenditures.
Therefore, under the National Health Programme, about 1,50,000 (public health centres) will soon be converted into wellness centres, if the Union Health Ministry has its way. The Ministry is reaching out to private sector participation in the programme as well. The goal is to screen everyone the age of 30 for major ailments like BP, diabetes, mental health, geriatric problems, oral cancer, cervix cancer, breast cancer and eye screening, Nadda said, while speaking at the LV Prasad Eye Institute here recently. “We have projected to have 150,000 health and wellness centres by 2020. There is a road map. At this point, 2,500-plus are ready, and by the end of the year, we will cross 10,000. Next year, we’ll add 40,000 and keep scaling it up. The reason why it is 10,000 to 15,000 initially is because manpower is being trained. Once we have trained staff and more trainers, we will scale up,” said Health Minister J.P. Nadda .
Finally, the power of technology to solve the last mile in primary healthcare is immense and given the scale of India’s healthcare deficit in primary care, this should be looked at with all the seriousness. Technology-based solutions to improve India’s primary healthcare will be faster, reliable and cheaper.
All put together, an approach that acknowledges the gravity and diversity of the situation and involves the community itself will be able to provide a lasting solution to India’s looming health crisis.