Pradhan Mantri Jan Arogya Abhiyaan

24/9/2018 209 Social Issues | Health | View Recent Current Affairs

  •  Prime Minister Narendra Modi rolled out the Centre’s flagship scheme — Pradhan Mantri Jan Arogya Abhiyaan, also known as Ayushman Bharat or the National Health Protection Mission (AB-NHPM).

What is Ayushman Bharat?

  • The Ayushman Bharat is a scheme that aims to provide health assurance to 10 crore families or around 50 crore Indians, who will be given up to Rs 5 lakh cover per year.
  • The scheme targets the poor, deprived rural families and identifies an occupational category of urban workers' families, 8.03 crore in rural and 2.33 crore in urban areas, as per the latest Socio-Economic Caste Census (SECC) data.
  • The health ministry has included 1,354 packages in the scheme under which treatment for coronary bypass, knee replacements and stenting among others would be provided at 15-20 per cent cheaper rates than the Central Government Health Scheme (CGHS).
  • The scheme will provide cashless and paperless access to services for the beneficiary at the point of service. Eligible people can avail the benefits in government and listed private hospitals.

Who can avail and how?

  • The entitlement is being decided on the basis of deprivation criteria in the SECC database. The beneficiaries are identified based on the deprivation categories (D1, D2, D3, D4, D5, and D7). For the urban areas, the 11 occupational criteria will determine entitlement.
  • In addition, the Rashtriya Swasthya Bima Yojna (RSBY) beneficiaries in states where it is active are also included.
  • There is no cap on family size and age in the scheme.
  • Aadhaar card is not mandatory. One would only need to establish one's identity to avail benefits under the scheme which can also be done through election ID card or ration card.

How a patient can access care under PMJAY?

  • In case of hospitalisation, members of the beneficiary families do not need to pay anything under the scheme, provided one goes to a government or an empanelled private hospital.
  • The National Health Agency (NHA), the apex body implementing the AB-NHPM, has launched a website (mera.pmjay.gov.in) and a helpline number(14555).
  • Each empanelled hospital will have an 'Ayushman Mitra help desk' where a prospective beneficiary can check documents to verify the eligibility and enrolment to the scheme.
  • All the beneficiaries will be given letters having QR codes which will be scanned and a demographic authentication conducted for identification and to verify his or her eligibility to avail the benefits of the scheme.

Analysis:

  • According to health ministry officials, the 71st round of National Sample Survey Organization (NSSO) revealed that 85.9 per cent of rural households and 82 per cent of urban households have no access to healthcare insurance/assurance.
  • More than 24 per cent households in rural India and 18 per cent population in the urban area have met their healthcare expenses through some sort of borrowing. The Ayushman Bharat intends to change this status quo.
  • According to Niti Aayog member VK Paul, who is the chief architect of the scheme, in the current fiscal the burden on the Centre is likely to be around Rs 3,500 crore, which is why it is being termed as the world's largest healthcare scheme. It will be funded with 60 per cent contribution coming from the Centre and remaining from the states.

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