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India Makes Huge Leap Towards Universal Health Coverage

Story Highlights
  • 1. Press the paddle on structural reforms. GDP growth slowdown could act as an opportunity to push forward structural reforms pending for years.
  • 2. Push public and private investments. Investments are the key driver of growth.
  • 3. Enhance rural wages. It will help boost consumption and demands. Anticipation of demand is what the companies use for investments.
  • 4. Rationalisation of corporate tax is critical. The loss incurring due to the cut in corporate tax would be made up by the resulting increase in personal income tax.

India has made a huge leap towards the universal health coverage with introduction of Ayushman Bharat scheme that ensures comprehensive healthcare to over half of the population at the bottom of the pyramid.

According to Vinod K Paul, Member, NITI Aayog, the total number of beneficiaries covered under the scheme is around 65 crore. This is despite a couple of states not joining the scheme. Originally the number of beneficiaries under the scheme was estimated to be around 50 crore or 40 per cent of the total population. Paul said several states have increased the scope of the scheme with a view to ensure that the benefit reaches to the larger section of the society. For example, in Uttarakhand the entire population is covered under the scheme.

Vinod K Paul, Member, Niti Aayog
“We are looking at a holistic change in the health system. Supply side is yet to respond, we expect huge investments to come. We need to double the number of hospital beds and increase the number of doctors.”

Beneficiaries of the Ayushman Bharat scheme are identified based on the deprivation criteria specified in the Socio-Economic Caste Census (SECC). Some states provide Ayushman Bharat benefits even to the people who are not part of the deprived category as per the SECC. The cost of providing services to the additional population is borne fully by the respective state governments.

While a lot has been talked and written about Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the scheme is also focused on bringing transformation in the primary healthcare system. The government has set a target to set up 1.5 lakh health and wellness centres under the Ayushman Bharat scheme that would provide comprehensive primary healthcare services.

There is a fundamental change in the approach to providing health services from the government. Before the implementation of Ayushman Bharat, the government health system was focused on limited priorities, targeted at specific diseases or health issues. Way back we were focused on Malaria control, then we got our focus on reproductive health and family planning, maternal health, child health and other communicable diseases, that’s what you hear about national programmes.

“If you look at the total need of the primary healthcare, we left out almost 80 per cent. It comprises non-communicable diseases like hypertension, diabetes, cancer, mental health, etc,” said Paul adding all communicable and non-communicable diseases and health related issues would be focused under the primary healthcare segment of Ayushman Bharat.

“Now India has changed, aspirations of the people have changed. The vision of comprehensive primary healthcare is that, now cover all conditions, all that it takes for us to be healthy,” he added.

Announced in February 2018 as part of the General Budget 2018-19, Ayushman Bharat has two parts. The first is setting up 1.5 lakh health and wellness centres to provide comprehensive healthcare, including for non-communicable diseases and maternal and child health services. These centres will also provide free essential drugs and diagnostic services.

The second part of the scheme is related to providing insurance coverage upto Rs 5 lakh per family per year for secondary and tertiary care hospitalisation. Over 10 crore families of deprived sections of the society are covered under the scheme.

According to Paul, over 63 lakh individuals have benefited from the insurance scheme so far. Every nine minute one patient is being admitted under the PMJAY scheme. 

“We are looking at a holistic change in the health system. Supply side is yet to respond, we expect huge investments to come. We need to double the number of hospital beds. We need five times the number of specialist doctors. We invite investments in health sector in a big way from NGOs as well as for-profit private sectors, aligned to the system,” said Paul.

Vinod K Paul

Prof. Vinod Paul, a pediatrician by training, has been on the faculty of the Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, since 1985, and head of the department for nearly a decade. Prof. Paul is a fellow of all the three science academies of the country, and a recipient of the Dr. R. Ambedkar Centenary Award for Excellence in Biomedical Research and the Public Health Champion award. He has conferred the prestigious san Dogramaci Family Health Foundation Prize by WHO at the 2018 World Health Assembly.
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