Union Health Minister J P Nadda chairs a meeting to review the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) and Ayushman Bharat Digital Mission (ABDM) with senior officials of the National Health Authority (NHA), in New Delhi.
Credit: PTI File Photo
The government’s decision to extend the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to all senior citizens above the age of 70 is welcome and would make the right to healthcare real for a much larger population. The scheme will be available to everyone above 70 years irrespective of income. It offers Rs 5 lakh annual health coverage and will benefit about 60 million more people from 45 million families. About 20% of the population will be over 70 by 2050. Most of them will need welfare support, including health facilities. At present, less than 20% of the elderly are covered by various health safety nets. However, there is the need to address some of the key issues that may arise with the expansion of the scheme.
Hospital facilities are already stretched under the current scheme. The proposed expansion will put more pressure on them. More than 30,000 hospitals and health centres, including 13,582 private facilities, are empanelled under the Ayushman Bharat scheme. A Comptroller and Auditor General (CAG) report has said that many states had between two and 10 empanelled hospitals per 100,000 people. That is very inadequate. So the government will have to enhance the health infrastructure and facilities to cater to the new demand. Even when the scheme offers healthcare, it should be noted that it does not solve the problem of out-of-pocket expenditure which puts a serious burden on patients and families. These expenses in India are more than twice the world average. There are also issues relating to faulty implementation. Many hospitals have complained that the rates are low and reimbursement is delayed. There have also been reports about hospital authorities, including doctors, discouraging patients and families from availing benefits under the scheme because of the formalities and additional work involved. These problems need to be resolved. The government has the responsibility to administer the scheme efficiently so that it reaches everyone who needs it.
Unfortunately, the launch of the scheme was marked by a jarring political note. Two Opposition-ruled states, West Bengal and Delhi, chose to opt out of it, and Prime Minister Narendra Modi said that they had done so due to “political interests.” The Chief Ministers of the two states have claimed that they offered better healthcare schemes to their citizens. Delhi, in fact, has a healthcare model that has won international praise. But it should be noted that Kerala and Tamil Nadu, two other Opposition-ruled states which offer good healthcare schemes, have allowed the PM-JAY to be operational.