Representative image of senior citizens.
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The extension of coverage under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to all citizens aged 70 years or above is an important health security measure and will be widely welcomed. It fills a major gap in the health insurance programme and will benefit over six crore senior citizens in 4.5 crore families, regardless of their socio-economic status.
The measure was part of the BJP’s electoral promises this year, and the Union cabinet approved it on Wednesday. It is expected to cost Rs 3,437 crore in the first year and will also cover those covered by private health insurance policies and the ESI (Employees’ State Insurance) scheme. Those covered by the CGHS (Central Government Health Scheme) and some other schemes will have to choose between their existing schemes and the new scheme.
The scheme has some limitations. A senior citizen is eligible for an insurance coverage of Rs 5 lakh under it. But if there is more than one person eligible for the scheme in a family, the benefit will have to be shared between them. If the eligible persons belong to families which are already covered under the Ayushman Bharat scheme, the benefit will not have to be shared.
The scheme is to be rolled out very soon. Its usefulness, even with its limitations, cannot be overstated. The potential beneficiaries are very large in numbers and it is good that the government has reached out to them. Health is among the most basic needs of life, especially for senior citizens, and the State has the responsibility to provide for and support them over it. Health insurance coverage is very low in the country. Just about 27% of the population is covered by it, and that shows how valuable any health protection scheme is, especially for vulnerable sections like senior citizens. It is an important social welfare measure.
There is scope for the government to go further on its health schemes. Most of the existing schemes, with the exception of some like the CGHS, cover only hospitalisation and related expenses and are not applicable to OPD or out-patient services.
It has been estimated that 50-80% of the annual medical expenses of citizens are on account of OPD consultations, tests, and the cost of medicines. People have to spend large amounts of money on these counts and many are unable to do so. There is a case for deepening and expanding the present schemes to new areas, if necessary by adopting elements from well-run public health schemes in other countries. Problems in the implementation of the Ayushman Bharat scheme, related to inadequate infrastructure, corruption, refusal of treatment, etc., should also be resolved for the best outcomes.