Ayushman Bharat Promises Quality Healthcare for the Poorby Opinion Express September 25, 2018 0 comments
Now that India’s biggest health insurance cover, the Ayushman Bharat National Health Protection Mission (AB-NHPM), has been rolled out promising quality care to 40 percent of poorer Indians, focus must shift to its effective and sustainable implementation. Otherwise, it will be consigned to being the big bang that turned into soda pop without the buck. For, if successful, the scheme will not only set several records but empower the poor with a confidence they have never had, burdened as they have been with out-of-the-pocket expense for even routine health care protocols. For the first time, they will have access to quality hospital treatment, one that will improve national health and productivity indices.
For the first time, the massive health insurance cover could make India proudly declare what it declares in statute books — a welfare state. The scheme is even wider in scope than the existing Mediclaim and holds out hope for the disadvantaged elderly population too as it covers pre-existing diseases, mental health and congenital diseases. There’s virtually no red tape involved as policyholders can walk into a hospital with their Aadhaar card number and be treated.
The network of hospitals proposed to be created will be larger than what insurers have today. Healthcare in India is in a shambles and this is perhaps the first scheme that seeks unified involvement of the government, policy makers, private players and stakeholders. Obviously, this is a dream idea, coming appropriately in a pre-election year and is easier for the ruling party to sell as a visionary step taken in the right direction with right intent and, therefore, encashable as a plank arguing for continuity of a regime. After all, the BJP has even tackled dissenting states through a trust model, where the Opposition-ruled state governments are partnering it, hard selling their own existing healthcare programmes and tagging Ayushman as an add-on.
The real story though is whether the public and private health infrastructure network can support a grand idea and whether the required budgets can be met. Most importantly, can we keep funds flowing and stakeholders invested? There is an urgent need to develop quality infrastructure and capacity-building in the deeper pockets where private hospitals, too, are wary of venturing simply because they cannot rationalise a low-cost set-up or packages. There is need to incentivise creation of a health network at the grassroots level. One must convert the number of insurers as a bait for private operators to extend their community outreach. The public healthcare network of primary health centres and community health centres needs to be buffed up before the private network can. We need more qualified doctors, leave aside specialists, to serve at public hospitals.
Going by the government rolls, there is just one doctor for every 11,082 people, according to the Medical Council of India and Directorate General of Health Services. We spend about 1.30 percent of our GDP on health which is below what low-income countries spend on healthcare. The budget allocation for Jan Arogya Yojana is still not substantial at Rs 2,000 crore. Providing cover is one thing but when the claims cascade and payouts are made in tumbles, it could mean a huge burden on the exchequer for which a foreseeable cushion has to be readied and the current allocation is not enough for it. Yet.
Writer & Courtesy: The Pioneer