Ayushman Bharat aka PM-JAY aka National Health Protection Mission aka Modicare will subsume Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
Modi government’s flagship healthcare scheme Ayushman Bharat is all set for the roll-out today. Prime Minister Narendra Modi will launch the programme from Jharkhand on Sunday. The ambitious healthcare scheme aims to provide a coverage of Rs 5 lakh per family annually.
While the scheme is being readied for the launch, there are some concerns over lack of clarity on the fund allocation and non-cooperation by some states. Ayushman Bharat aka PM-JAY aka National Health Protection Mission aka Modicare will subsume Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
The government will likely cap annual premium outgo for the ambitious Pradhan Mantri Jan Arogya Yojana (PM-JAY) at Rs 1,110/family. In the Budget 2018, Rs 1,200 crore was allocated for 1.5 lakh health and wellness centre that will provide free drugs and diagnostic services to identified beneficiaries. The Centre and states will share the scheme’s estimated annual cost of around Rs 12,000 crore in a 6:4 ratio.
However, this budget is low. If compared with RSBY, Ayushman Bharat aims to provide larger insurance cover to a larger population at a lower premium. FE Online had reported earlier that how at the budget of Rs 11,000 crore, the premium per family will be Rs 1,082.
This is much lower than average premium of Rs 1,765 for an average claim of Rs 20,000 per family under RSBY. Ravi Menon, senior healthcare sector advisor, SKP Business Consulting LLP, also told FE Online that the budget of Rs 10,000-11,000 crore to roll-out such a humungous programme is “prima facie low”.
Rating agency Care Ratings also noted that even if government estimates of a premium is Rs 2,000 per year, it may not go “well with the private insurers”. For now, some states are opting for the trust-based mode instead of insurance companies. Under trust-based mode, trusts or the government itself pays for the claims instead of insurance companies, which is likely to put more burden on the exchequer.
Besides funding of the scheme, non-cooperation from states — Delhi, Telangana, Kerala, Punjab, and Odisha — is also a concern. These states have not joined the programme yet and want to continue with their state-level healthcare schemes. A day ahead of the launch, Narendra Modi asked the Odisha government to link the beneficiaries with the Ayushman Bharat scheme.
Health Minister J P Nadda said that 30 states and union territories have signed MoU with the central government for the implementation of the scheme. A pilot project of the scheme was launched in 22 states and union territories.
Despite these concerns, the concept of providing insurance cover to the poorest of Indians is a long-term game. “Despite the low budget, I believe that this does not reflect any ‘smoke and mirrors’ strategy as some may perceive it. The government’s intention is to make a quantum change in health insurance availability among the underserved,” Ravi Menon said.
“A phase-wise rollout of the scheme will allow the government to evaluate and titrate the budgetary burden. Although, the government will need to work closely with healthcare providers and suppliers to significantly bring down treatment costs from current market prices,” he added.
The National Health Agency (NHA), the apex body implementing the Ayushman Bharat has launched the official website and a helpline number to help prospective beneficiaries check if their name is there in the final list. The work on providing the IT backbone for the implementation of the scheme was completed last month.
First published on September 22, on www.financialexpres.com