02 June- 09 June 2019

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AYUSHMAN BHARAT: Path to privatization?

Reference Article: Cover Story from Frontline by Vikhar Ahmed Sayeed

Context

ON September 23, 2018, Prime Minister Narendra Modi launched the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in Ranchi.

About Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

  1. It is biggest “government-sponsored health care system in the world”. Targeted at poor, deprived rural families and specific occupational categories of urban workers’ families.

 

  1. Its stated aim is to provide them secondary and tertiary care such as advanced surgical interventions.
  1. The scheme, with a cover of Rs.5 lakh a family, is to benefit 10.74 crore families, approximating 50 crore beneficiaries.

 

Pradhan Mantri Jan Arogya Yojana: Shadow or substance


  1. In the five months that the scheme has been operational, besides gaps in its implementation, serious flaws have been detected that may eventually lead to large private hospitals and private insurance companies benefiting, with the government acting as a broker.

 

  1. Even when the scheme was launched, there was criticism by many opposition-ruled States. Karnataka, for instance, had a successful health coverage system under 10 separate schemes that had come into force over the past 15 years. Thus, these states are reluctant to join the scheme.

Other issues with Pradhan Mantri Jan Arogya Yojana

  1. Middle-class patients who availed themselves of health care benefits under the various schemes in the past were unable to get the benefits of ABAK as they needed a referral from a government hospital, which is hard to come by.

 

  1. The second problem was that the beneficiaries were unaware of the fine print of the AB-PMJAY. “They think that any treatment or surgery up to Rs.5 lakh is free, but this

is not true. For example, if a woman undergoes a caesarean section while delivering a baby, the compensation is only Rs.7,000, which is unimaginably low.

  1. The third and perhaps the most serious problem is that some ailments or parts of treatment that were covered earlier have been removed under the ABAK.

 

AYUSHMAN BHARAT: Path to privatization?

  1. A significant point of worry with schemes like the AB-PMJAY is that with the encouragement of health insurance models, governments move away from their responsibility of strengthening public health institutions.
  2. The move towards the insurance model is worrying as it weakens the public delivery system and promotes utilization of facilities at private hospitals.
  3. There is an overdose of medicalization as the patients are insured. This only leads to a maximization of profit of private hospitals and private insurance companies without strengthening the public health system.
  4. The argument that under health insurance schemes such as the AB-PMJAY, access to private hospitals would provide a larger number of health facilities. “This is a flawed argument as the nearest empaneled private hospital in a rural area is usually at the district headquarters and at least 50 to 100 kilometers away.

Conclusion

  1. In the present form the Ayushman Bharat falls short of the PM Modi promise of increasing the access, improving the quality and lowering the cost” of health services with the goal of providing “Health assurance to all Indians and to reduce the out of pocket spending on health care.
  2. The goals of Ayushman Bharat are novel, however privatization of everything does not help in achieveing these novel goals.

  1. The Union Government rather than air dropping a new should try to supplement and replicate successful health programs of some states like Karnataka (Arogya Karnataka), Kerala (Karunya Arogya Suraksha Paddhati (KASP) etc.

Keynotes/Keywords from Article:

  1. The article presents a critique of Ayushman Bhart Programme.
  2. If you want to make complete use of this article than try to rewrite in a shorter format without losing the essence.
  3. This Article is very important for essay paper. As it helps to think in 360 degree.

ASSIGNMENTS
Question for Mains:

Goals of Ayushman Bharat are novel, however privatization of everything does not help in achieving these novel goals. Comment (250 words).

  1. First, focus on word comment. You need to take a side here.
  2. Introduce by stating objectives and goals of Ashman Bharat.
  3. Then explain how it is encouraging privatization of health industry.
  4. Bring some negative points of privatization of healthcare.
  5. You can mention about responsibility of state for taking care of health of citizens.
  1. Finally conclude by giving some suggestions like developing health infrastructure by state. Need

to increase the no of qualified doctors,          introduction of diploma in primary healthcare.

MCQ
Consider the following statements National Health Authority:

  1. It replaced the National Health Agency.
  2. National Health Authority as an attached office to Ministry of Health & Family Welfare.
  1. It is created for implementation of Pradhan Mantri - Jan Arogya Yojana (PM-JAY). Which of the above statements are Correct?

 

  1. 1 only
  2. 1 and 2 only
  3. All of the above
  4. None of the above

Answer: C

Explanation: For better implementation of Pradhan Mantri - Jan Arogya Yojana (PM-JAY)."National Health Agency" has been dissolved and will be replaced by National Health Authority as an attached office to Ministry of Health & Family Welfare

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