Ayushman Bharat

Ayushman Bharat 

Prime Minister Narendra Modi recently 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).

Significance of the project:

• This is the world’s largest health scheme which will serve a population that equals 27-28 European countries. The beneficiaries are almost equal to the population of Canada, Mexico and US put together.
• Meant to help the poor and the economically deprived, the scheme will be available for 10.74 crore beneficiary families and about 50 crore Indian citizens.

Ayushman Bharat:

• Ayushman Bharat is the National Health Protection Scheme, which will cover over 10 crore poor vulnerable families (around 50 crore beneficiaries) providing coverage of up to ₹5 lakh (per family per year) for secondary and tertiary care hospitalisation.
• It will subsume the on-going centrally sponsored schemes –Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

Highlights of the scheme:

Coverage: The scheme has the benefit cover of Rs. 5 lakh per family per year. To ensure that nobody is left out (especially women, children and elderly) there will be no cap on family size and age in the scheme. The benefit cover will also include pre and post-hospitalisation expenses.

Target: The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population based on SECC database. Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospitals across the country.

Role of state governments: State Governments will be allowed to expand AB-NHPM both horizontally and vertically. States will be free to choose the modalities for implementation. They can implement through insurance company or directly through Trust/ Society or a mixed model.

Council: For giving policy directions and fostering coordination between Centre and States, it is proposed to set up Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) at apex level Chaired by Union Health and Family Welfare Minister.

Who is eligible?

• It will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the SECC database.
• The different categories in rural area include families having only one room with kucha walls and kucharoof; families having no adult member between age 16 to 59; female headed households with no adult male member between age 16 to 59; disabled member and no able bodied adult member in the family; SC/ST households; and landless households deriving major part of their income from manual casual labour.
• Also, automatically included families in rural areas having any one of the following: households without shelter, destitute, living on alms, manual scavenger families, primitive tribal groups, legally released bonded labour. For urban areas, 11 defined occupational categories are entitled under the scheme.

Why Ayushman Bharat?

• According to health ministry officials, the 71st round of National Sample Survey Organization (NSSO) revealed that 85.9% of rural households and 82% of urban households have no access to healthcare insurance/assurance.
• More than 24% 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.

Sources: the hindu.