In the first year, the momentum has been quite good and we are quite pleased with the way the scheme has rolled out, says Bhushan
About 70 per cent Indians rely on private healthcare for their health needs and bear out of pocket costs, which plunged 55 million people into poverty in 2012. India has earlier tried out national insurance models such as the Rashtriya Swasthya Bima Yojana (RSBY) that started in 2008, aiming to cover hospitalisation expenses upto Rs 30,000 for families below the poverty line. Its overall performance was poor and the scheme failed to reduce impoverishment.
In September 2018, Prime Minister Narendra Modi launched the ambitious Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the National Health Protection Scheme, in Ranchi, Jharkhand. The scheme that subsumed RSBY provided an insurance cover of Rs 5 lakh to 100 million ‘poor and vulnerable’ families identified by the socio-economic caste census (SECC) of 2011.
More than a year later, we spoke with Indu Bhushan, the chief executive officer of AB-PMJAY and the National Health Authority (NHA), which is responsible for implementing the scheme. “We have gone beyond RSBY,” said Bhushan, sitting in his seventh floor NHA office on New Delhi’s Janpath. By December 2, 2019, PMJAY has covered over 6.8 million hospitalisations worth Rs 7,160 crore and has issued over 67 million e-cards to beneficiaries, according to PMJAY website and NHA. It is present in all but four states–Odisha, Telangana, West Bengal and New Delhi.
Pointing to the large screen showing the PMJAY dashboard, Bhushan said two-thirds of the hospitalisations were in private hospitals and for tertiary care. “So we are taking care of problems like catastrophic expenditure,” Bhushan said. “We have spent Rs 8,000 crore, but the savings to people is Rs 15,000 crore.”
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