Ayushman Bharat- wellness is a journey to healthy India

“In the face of overwhelming statistical probabilities ,health has always

seem to me to be the only rational position to take on life”
Healthcare coverage is provided through public and private medical sectors.
The aim of these healthcare coverages is universal provision of curative care
and diagnostic services. The four basic types of healthcare models
are:Beveridge , Bismarck , out of pocket and national insurance model. The
American healthcare system hinge upon insurance model which is being
adopted by Indian government under the name of Ayushman Bharat.
On 25rd September 2018 world’s largest government funded healthcare
scheme also called PM Jan arogya yojana became operational. The scheme
targets poor deprived rural families of occupational category and urban
worker families. The sole motto of this scheme is to cover both preventive
and pro-motive health to address healthcare holistically . 10.74 crore people
are eligible to get benefits of the scheme that include support for the pre
and post hospitalization costs, empaneling of the private sector hospitals
and promulgating E-health cards . The benefit can be availed via cashless
transactions and hassle free treatment without paying bills prior to the
treatment .Health ministry and Central government aims to provide cost
free medical facilities and treatment to people belonging to the BPL sector.
It includes digitization of the healthcare which will make it more transparent
as one could keep up with the data in track trends rather than paper based
healthcare. According to the data of SECC-2011 (socio economic caste
census) 8.03 crore families in rural and 2.33 crore families in urban areas are
entitled to be covered under this scheme . It has defined benefit cover of 5
lakh per family on the floater basis for secondary and tertiary care
hospitalization.
US spends over a $ 8250 per capita on healthcare every year, then over 22%
higher than next higher country in the world. Even then whole of the
population is not under scope of receiving benefit. Contradictory to this
India’s healthcare allocation is nearly 1% of GDP with number of citizens
outnumbering that of America and taking into consideration the following
factors there are sleek chances of success of ayushman Bharat
 Harmonizing the conference held at AIIMS Delhi, sources said , the main
thrust of any healthcare program should always be on improving and
strengthening public healthcare infrastructure as insurance is always less
efficient than direct provision of Health services by the government.
The insurance healthcare system is assessed upon the basis of its access,
cost and quality. As for access, the scheme should have universal coverage,
not all sectors of society are covered in ayushman Bharat . Lower middle
class families spend almost whole of life savings on healthcare that turns out
to be catastrophic amount . Secondly insurance healthcare system comes
out to be the most expensive healthcare system in the world per capita,
India being a developing country with little of its GDP attributed to
healthcare can’t come out at its best following the system. Thirdly the
quality , public health care centers have poor infrastructure and
technological supportive equipment and it needs better standardized
facilities , because outcome will be nil if clinicians in government sectors
aren’t provided with basic treatment accouterment .
The crux for low healthcare quality lies in the fact that current budget for
healthcare has slashed by 20% . The upliftment of public sector healthcare
can be initiated by allotting more of the financial support to public hospitals
.
Medicinal treatments are provided either free or at the nominal cost to BPL
and underprivileged citizens in the rural and the urban government medical
hospitals, accounting that Health insurance is of no use to them . Moreover
many of them don’t have internet access and aren’t even aware of the
scheme. Due to lack of internet access people tend to face lot of hurdles to
avail the benefits and to enrolling for the scheme.
Ayushman Bharat doesn’t provide outpatient department care support
which contributes as major component of health expenditure and is as
expensive as in patient care. Medicines , drugs of treatment and other
secondary expenses after the discharge of patients influence the pockets of
the people. The major lacking lies in secondary and tertiary care which are
scarce in supply in many states .
This scheme ensured that each beneficiary gets advantage on fairly basis
both state and central government was supposed to raise the funds in
40:60 ratio for implementation of the scheme but due to political conflict
West Bengal withdrew from the scheme that emerged as major lagging
factor for success of the scheme.
There is enormous scope for corruption that the scheme can lead to, from
enrollment stage to billing , every next step can pave the way for money
slipping into pockets of concerned authorities .
The cause of high mortality rate is lack of suitable healthcare facilities and
healthcare professionals ,there should be improved focus on attaining
better healthcare by improving and encouraging startup investors alike to
help find effective healthcare solutions, nature of services being provided
that will play pivotal role in making the scheme a success , rather
government should focus on developing more number of Health care
centers nationwide within approachable distance for poor people because
many people die on the way to hospitals due to lack of paramedical facilities
even if they make through, some give their way of due to lack of primary
medical equipment. I myself have witnessed a death due to lack of
defibrillator in the health center . cost of setups of such standardized
medical equipment is high enough but they are worth deployment.
Lastly, If the claim rates exceed the budget allotted for this scheme this
could turn out to be a major backfire . Taking into consideration the merits
and demerits of this scheme , if the health ministry looks upon the
shortcomings of the scheme and takes effective remedial measures ,this
scheme can change the current scenario of health related issues.

Submitted by : Simran Spal

College: Punjab Institute of Medical Sciences , Jalandhar