Non-Aligned Movement has urged Member States to implement and advance universal health coverage that comprise equitable access to quality health services and ensure affordable and quality service delivery, especially through primary health care and social protection mechanisms. In this regard, the Ayushman Bharat Yojana in India, launched by Indian Prime Minister Narendra Modi in September 2018 as a part of National Health Policy 2017, is an important milestone to achieve the vision of universal health coverage.
This initiative has been designed to meet the underlying commitments in the Sustainable Development Goals (SDG). Goal 3 of the SDG calls for ensuring healthy lives and the promoting the well being of all ages and also calls for providing more efficient funding of the health system. In line with these commitments, Ayushman Bharat Yojana entails two major components. First, the scheme aims at establishing health and wellness centre in order to ensure the delivery of comprehensive primary healthcare for all, especially the underprivileged and the vulnerable people. These health and wellness centre will provide free diagnostic services and give access to free of cost essential drugs. Second, the scheme establishes a National Health Protection Scheme (NHPS) under which every eligible family is entitled to an insurance benefit of up to INR 5 lakhs per year in any private (empanelled) or public hospital across the country. This enables beneficiary’s cashless treatment at any secondary and tertiary health care facility.
Under the ambit of Ayushman Bharat, a Pradhan Mantri Jan Arogya Yojana (PM-JAY) to reduce the financial burden on poor and vulnerable groups has been conceived. Pradhan Mantri Jan Arogya Yojana (PM-JAY) will provide financial protection (Swasthya Suraksha) to 10.74 crore poor, deprived rural families and identified occupational categories of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data (approx. 50 crore beneficiaries). The 11 occupational categories of workers include rag pickers, beggars, domestic workers, street vendors, cobblers, hawkers, other service providers working on streets, construction workers, plumbers, masons, labours, painters, welders, security guards, coolies and other head-load workers and sanitation workers.
The scheme will also offer a benefit cover of Rs. 500,000 per family per year (on a family floater basis). In order to ensure that the scheme is comprehensive, no cap has been laid down on the family size and age. PM-JAY will cover medical and hospitalization expenses for almost all secondary care and most of the tertiary care procedures. PM-JAY has defined 1,350 medical packages covering surgery, medical and day care treatments including medicines, diagnostics and transport. When fully implemented, the Ayushman Bharat Yojana will become the world’s largest government funded health mission.
Ayushman Bharat scheme has come in for praise worldwide from organisations and institutions related to health. Director General of the World Health Organization (WHO) Mr Tedros Adhanom Ghebreyesus wrote on social media that he was very impressed by this Indian initiative on universal health care and commended the commitment of Indian government to make healthcare accessible and affordable for all. Earlier, in March 2018, Ghebreyesus had remarked that the “new National Health Protection Scheme has the potential not only to improve health but to help lift people out of poverty”.
British medical journal Lancet has praised Indian Prime Minister Narendra Modi for grasping the importance of heath as a natural right for all citizens and to prioritise universal health coverage. In an article titled “The New Politics of Health in India”, Lancet’s editor-in-chief Richard Horton remarks: “Under a new initiative called Ayushman Bharat, launched this year, Prime Minister Modi has implemented two new flagship programmes. First, the creation of 150 000 health and wellness centres across the country. These centres will provide a spine of primary care facilities to deliver universal health coverage. Second, the National Health Protection Mission (NHPM)—a system of health insurance that intends to cover 500 million people. The financial risk protection offered by the NHPM is equivalent to €6265 per person annually. It covers secondary and tertiary care for the poorest and most vulnerable families.” Thus, the Ayushman Bharat Scheme has the potential of changing the landscape of the healthcare sector in India and accomplishing the target of universal health coverage in the country.
By Dr. Ankit Srivastava