AYUSHMAN BHARAT: COUNTDOWN BEGINS
Under the
chairmanship of Prime Minister Narendra Modi, the cabinet’s approval of Ayushman
Bharat-National Health Protection Mission ( AB-NHPM) on 21st March officially sets the ball rolling
for the implementation of an extremely ambitious and hugely challenging centrally
sponsored flagship programme of BJP Government. The programme is considered to be
a brain child of Shri Narendra Modi and hence it is aptly labeled MODICARE ,just like OBAMACARE.
It is
expected that Prime Minister Modi shall make an announcement of this programme
on 15th August 18 from the ramparts of the Red Fort with a promise to make it fully functional most
probably from 2nd October in memory of Mahatma Gandhi. It shall be a
befitting tribute to our beloved Father of Nation since this programme involves
great relief to 40 percent of our relatively less privileged population. The programme shall benefit 10.36. crore
families with approximately 50 crore individuals. Each family shall have the privilege
of insurance for Rs. 5.0 lakh providing them cashless and paperless facilities
in public and empanelled private hospitals for 1347 listed secondary &
tertiary packages as well as pre and post hospitalization expenses. It shall include pre-existing diseases and
there shall be no cap on family size
and age. A defined transportation
allowance per hospitalization will also be paid to the beneficiary in addition
to cashless expenses for the package. The state Governments shall be at liberty
to modify package rates within limited bandwidth depending upon the finance
available with the them. The states would be allowed to expand AB-NHPM both
horizontally & vertically. State can implement through insurance company or
directly through trust/society or a mixed model. One of the core principles of AB-NHPM is co-operative federalism and
flexibility to states.
There is a sense of political urgency since the success of
this challenging programme which is the largest welfare programme in the world
shall be a feather in the cap of our ambitious & probably the hardest
working & dedicated Prime Minister India ever had. Programme, if
implemented well with meticulous planning and coordination of centre, state governments,
hospitals and insurance or TPA’s of our country, it shall really bring health
& happiness to 10.36 crore (8.06 crore in rural and 2.33 crore in urban
area) families. The scheme will target
poor deprived rural families & identified occupational category of urban
workers’ families. This will give underprivileged families the financial
support required when faced with illness requiring hospitalization. The main
principal of AB-NHPM is to improve quality of care at secondary & tertiary
facilities, provide universal health coverage and make the services equitable,
affordable and accessible to most deprived needy population of the country.
Presently, health care & quality index ranks India a dismal 154th amongst
195 countries, worse than Shri Lanka or Bangladesh. The central budget
allocated for the programme is 10,000 crore
Frantic activities have already begun in the month of March under the dynamic leadership
of Union Minister for Health & Family welfare J.P Nadda along with two Ministers of State ,
Ashwin Kumar Choubey and Anupriya Sing Patel.
For giving policy directions and fostering coordination between the
centre and states, AB-NHPM council has
been setup under the chairmanship of Health Minister. A governing Board shall
also be created which shall be chaired by Health Secretary with membership of
Niti Aayog’s Financial Advisor. The greatest challenge is to identify such
10.36 crore families. For the implementation, Health Ministry and Gram Swaraj Abhiyan of Rural Development
Ministry is working overtime to achieve the target. The poor & vulnerable
population based on Socio Economic & Caste Census (SECC) data base shall be
selected. AB-NHPM shall subsume the ongoing centrally sponsored schemes, Rastriya Swasthya Bima Yojna (RSBY) and
the Senior Citizens Health Insurance
Scheme (SCHIS), thereby providing more money for this programme.
As a
preventive measure, ministry is converting 1.5 lakh health sub-centers into
wellness centers, which will have universal screening for breast, cervix and
oral cancers along with care for diabetes, hypertension and other common ailments.
This step will ensure preventive, promotive and curative care & will assure
seamless continuum of care.
Optimum
costing has to be worked out for the identified packages with the cooperation
of professional bodies, hospitals, insurance companies and TPA’s of the
country. The operative procedure has to
be so elaborately worked out to provide prompt service to a patient and fast
disposal of bills of the hospitals by the insurance companies with all
precautions to avoid false and fabricated claims. For this, robust IT
infrastructure and proper monitoring is needed. IT system shall be the backbone
of AB-NHPM programme with all safe guards. Special Grievance Redressal cell
shall be established to address the grievance of patients and hospitals.
In short, the National Health Protection Mission will ensure
rapid advancement towards attaining universal health care through a substantial
reduction in expenditure and comprehensive approach adopted by the National
Health Protection Mission, safeguarding more than 50 crore people. Moreover, the
scheme is formulated to satisfy the unmet needs of the population which
remained hidden due to lack of financial resources. The scheme will contribute
immensely to the ease of living & enable beneficiaries to health facilities
resulting in better health and longer life span.
The programme is a double sided sword. The success of this
programme which shall be evident in the first few months of its launch &
shall assure resounding victory of Shi Modi in year 2019 if it is successful. Any
short coming, howsoever trivial it may be, shall be a great tool in the hands
of formidable united opposition to form it an election issue. We hope the implementation lives up to
intent.
Prof M R Jain MS, FICS ( USA), FACLP(LONDON), FAMS
Medical Director
Jain Eye Clinic & Hospital
Jaipur 302004
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