India’s biggest healthcare scheme, the Pradhan Mantri Jan Arogya Abhiyan (PMJAY), popularly known as Ayushman Bharat, is only two days away from its launch, but looks like, the government still does not have the implementation plan ready.
The plan was to be launched on September 25 but since Prime Minister Narendra Modi had a tight schedule on the day, the launch was preponed to September 23.
The healthcare scheme will be launched by Prime Minister Modi in Jharkhand on Sunday.
Under the scheme, the patients can go to hospitals and avail cashless treatment up to Rs. 5 lakh per annum for each family.
Under the scheme, the states and Centre, both, will contribute towards funds, but the ratio will differ from state to state. On the one hand, funding of most of the states will be shared in the ratio of 60:40 with Centre contributing the larger portion and on the other hand, states like Himachal Pradesh, Uttarakhand, Jammu and Kashmir and north eastern states will get funding in the ratio of 90:10, with Centre again, contributing the majority.
The Centre’s funding will be given to apex body, created by states to implement and monitor the scheme.
While many states have signed up for the scheme, states such as Telangana, Andhra Pradesh and Karnataka have not because they already have health insurance schemes in place which are far better prepared than Ayushman Bharat.
Earlier in June, the Association of Healthcare Providers India (AHPI) had written to the CEO of Ayushman Bharat, indicating towards their unwillingness to participate in the scheme, and said that the scheme’s proposed reimbursement package rates are unscientific, arbitrary and insufficient.
AHPI represents about 3,000 private healthcare institutions. “It appears that overall, no scientific basis has been applied to arrive at the rates,” said the letter written by the AHPI.
While signalling towards their unwillingness to participate in the scheme, it also said that the scheme would turn out to be ineffective on the ground if it fails to attract participants. “The participation of healthcare providers would be sparse and the Ayushman Bharat will remain grossly ineffective on the ground,” the letter read.
The Ayushman Bharat National Health Protection Scheme (AB-NHPS) was announced in the annual budget in February, in which an insurance coverage of Rs. 5 lakh per family was promised to about 10 crore of the poorest families. However, a comparative on the cost of medical procedures incurred by private hospitals verus what the government reimburses via the Central Government Health Scheme (CGHS) showed that the rates were much lower than what private hospitals had to bear.
Ayushman Bharat rates were already revised once after it faced criticism from the private sector, but it still fails to meet the expectations of the private sector.