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Can We Hope For A Healthier India With The Ayushman Bharat Scheme?
The National Health Policy introduced Ayushman Bharat in 2018, a flagship program of the Indian government, aiming to achieve the goal of Universal Health Coverage (UHC). This program was created to fulfil the Sustainable Development Goals (SDGs) and their core principle, "leave no one behind."
Ayushman Bharat was developed to move away from a sectoral approach towards a comprehensive need-based approach. This program aims to address the healthcare system holistically, including ambulatory care, promotion, and prevention at the primary, secondary, and tertiary levels.
Ayushman Bharat uses a care strategy that consists of two interconnected parts, namely -
● Health and Wellness Centres (HWCs)
● Pradhan Mantri Jan Arogya Yojana (PM-JAY):
PMJAY is one of the biggest health insurance programs in the world. With coverage for diagnostic tests, pre-hospitalization costs, and medical treatment costs, it offers a cover of Rs 5 lakhs per family per year. Additionally, PMJAY offers a paperless facility and a cashless health insurance feature.
Over 10.74 crore low-income families, or roughly 40% of all families in India, are covered by PMJAY.
Ayushman bharat scheme eligibility check:
The eligibility criteria are distinct for the rural and urban population. Let's roughly state both.
Rural population:
Families without an adult or a male adult member between 16 and 59 years of age, SC/ST, living in temporary shelters, tribals, etc
Urban population:
Domestic workers, street vendors, watchmen, laborers, construction workers, artisans in small-scale industries, beggars, rag-pickers, etc.
What are the advantages of the PMJAY program?
●
The
PMJAY
program
covers
pre-hospitalization
expenses
for
up
to
three
days
and
post-hospitalization
expenses
for
up
to
fifteen
days,
including
the
cost
of
diagnostics
and
medications.
●
There
are
no
limitations
based
on
family
size,
age,
or
gender.
●
Pre-existing
conditions
are
covered.
●
Daycare
expenses
●
Those
enrolled
in
the
program
have
access
to
paperless
health
insurance
and
other
services.
●
Nationwide
access
is
available
to
the
facilities
covered
by
PMJAY.
COVID'19: Was the Ayushman Bharat scheme a saviour?
The scheme aimed to curb the out-of-pocket expenditure of the poor and downtrodden but showed poor performance. The pandemic exposed the flaws in our healthcare system and the fact that implementation of small-scale solutions (like health insurance programs) won't have much of an impact in the long run. Poor implementation of policies, improper execution and corruption are to be blamed.
●
Many
states
had
their
own
health
programs,
which
collectively
covered
many
more
people
than
Ayushman
Bharat
intended.
●
The
scheme
collaborated
with
the
German
GIZ
as
a
consultant
despite
the
company's
poor
reputation.
●
The
available
data
supporting
the
eligibility
criteria
is
old.
A
number
of
beneficiaries
are
ineligible
at
present
as
per
the
outdated
criteria.
The
government
is
trying
to
cut
down
on
the
number
of
beneficiaries
due
to
a
lack
of
funds.
●
The
government-appointed
Third
Party
Administrators
lack
transparency
in
their
functioning.
With
over
13,000
hospitals
empanelled
under
the
scheme
and
cash
incentives
to
the
doctors,
it
is
disappointing
to
see
the
shoddy
state
of
affairs.
Current developments in the scheme:
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), the National Health Authority's (NHA) flagship program, has released a newly updated and dynamic public dashboard.
The state/UT perspective offers a transparent view of the scheme's development. It has a user-friendly interactive interface that presents the scheme's key performance indicators through instructive charts. It aims to give the general public and stakeholders an insight into the scheme's performance. The dashboard now includes information on the most popular procedures and specialities used by beneficiaries in hospitals enrolled in the program.
In a nutshell, we can say that human resources make this program successful. Empathy, honesty, and a vigilant monitoring system can help build a healthier India.