Thursday, June 21, 2018

AYUSHMAN BHARAT


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
E Mail: drmrjain55@gmail.com                                          16/05/2018



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