- The healthcare sector has welcomed Prime Minister’s announcement in his Independence Day address that the Pradhan Mantri Jan Arogya Abhiyaan, also known as Ayushman Bharat or the National Health Protection Mission (AB-NHPM), will be launched on September 25.
About Ayushman Bharat
- Ayushman Bharat is National Health Protection Scheme, which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization.
- Ayushman Bharat – National Health Protection Mission will subsume the on-going centrally sponsored schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
- Ayushman Bharat – National Health Protection Mission will have a defined benefit cover of Rs. 5 lakh per family per year.
- 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.
- Ayushman Bharat – National Health Protection Mission will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the Socio- Economic Caste Census (SECC) database, 2011.
- One of the core principles of Ayushman Bharat – National Health Protection Mission is co-operative federalism and flexibility to states.
- 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.
- States would need to have State Health Agency (SHA) to implement the scheme.
- To ensure that the funds reach SHA on time, the transfer of funds from Central Government through Ayushman Bharat – National Health Protection Mission to State Health Agencies may be done through an escrow account directly.
- In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction.
Benefits of Ayushman Bharat:
- Ayushman Bharat is an attempt to ensure that universal healthcare reached the weaker sections of society and it could raise the ratio of people availing primary and secondary healthcare.
- The government has made this a technology-driven initiative, which is a great step to ensure transparency and effective implementation, and at a grander scale, this initiative would encourage more work in development of overall health infrastructure in the country.
- Growing healthcare infrastructure in the country will help 50 crore poor people access medicines and essential drugs.
- Besides addressing the challenges of geographic inaccessibility and unaffordability, Ayushman Bharat had the potential of creating a cost-effective digitalised health economy and catapulting India to the league of developed nations.
- The current framework of the scheme will not be beneficial for people who need tertiary care as the remunerations under the scheme will not be sufficient to avail value-based healthcare.
- Under the scheme, tertiary healthcare service providers will be forced to cut cost at every level, which will lead to offering a sub-standard healthcare to patients under the scheme.
- They may not be able to avail the necessary medication, technology and clinical expertise to get the best outcome and will soon lose confidence in the system
- Today, nearly 80% of the healthcare in India is provided by the private healthcare system and in order to meet the burgeoning healthcare needs of Indian population through value-based medicine, the country needs a synchronised effort by both private and public sector.
- The government should look at mandatory universal health cover for all sections of society which will increase the pool and allow cross-subsidy between the government and the private sector.
What are Primary, Secondary and Tertiary heath care?
Health care delivery includes providing primary care, secondary care and tertiary care.
Primary Health Care:
- They are the basic first level of contact between individuals and families with the health system.
- The general practitioners, the family physician, the physiotherapist are the usual primary health care providers.
- Immunisation, basic curative care services, maternal and child health services, prevention of diseases are the type of services provided by PHC’s.
- Family planning, health education, provision of food and nutrition and adequate supply of safe drinking water may also be included in their services.
- In India, a network of sub centres and PHC’s work in rural areas to provide primary health care.
- Family welfare centres provide such services in the urban areas.
- The staff in a PHC includes a medical officer, a staff nurse, the pharmacist and other paramedical support staff.
Secondary Health Centre:
- Health care services, at such centres are provided by medical specialists.
- They may not have first contact with patients.
- Depending on the policies of the National Health System, patients may access these services through physician referral or self referral.
- Secondary health care providers include cardiologists, urologists, dermatologists and other such specialists.
- The health care services include acute care, short period stay in a hospital emergency department for brief but serious illness.
- There may be secondary care providers who do not work in hospitals – psychiatrists, physiotherapists, respiratory therapists, speech therapists and so on.
- In India, the District Hospitals and Community Health Centres at the block level are examples of Secondary Health Centres within the public health system.
Tertiary Health Centre:
- This is a specialised consultative health care for inpatients.
- The patients are admitted into these centres on a referral from primary or secondary health professionals.
- Tertiary health care is provided in a facility that have personnel and facilities for advanced medical investigation and treatment.
- Services provided include cancer management, neurosurgery, cardiac surgery and a host of complex medical and surgical interventions.
- Advanced diagnostic support services and specialised intensive care which cannot be provided by primary and secondary health centres are available at the tertiary health centres.
- In India tertiary care services under the public health system, is provided by medical colleges and advanced medical research institutes.