Five Years Of Caring
The flagship health protection scheme, Ayushman Bharat Pradhan Mantri Jan ArogyaYojana (AB-PMJAY) completes its fifth year. It is time to reflect on its strengths and achievements including its reducing out-of-pocket expenditure (OOPE), and efficient utilisation of the government budget.
- Fulfilment of SGD Goal- The scheme has taken the country closer to Sustainable Development Goal 3.8, which envisions universal health coverage.
- Bridge the Gap- The scheme has tried to bridge the shortfall between healthcare providers and service-takers.
- Reducing out-of-pocket expenditure- The scheme has catered to more than 5.39 crore admission events worth Rs.66, 284 crore in the last five years. The same care outside AB-PMJAY’s ambit would have cost nearly two times higher.
Reasons for the Success:
- Contribution of service providers- The success of the scheme can also be attributed to different stakeholders, especially service providers who collaborated for the implementation of PMJAY.
- Pradhan MantriArogyaMitras -Every hospital has Pradhan MantriArogyaMitras (PMAMs) who guide the beneficiaries who belong to underprivileged sections of society and face difficulty in accessing the healthcare services.
- Interstate portability- An important feature of AB-PMJAY is interstate portability. This means a patient registered in one state is entitled to receive care in any other state that has an AB-PMJAY programme.
- Ayushman Card- In order to realise the scheme’s full potential, the National Health Authority (NHA) along with its counterparts in the states should aim to provide every possible beneficiary with an Ayushman Card.
- Settlements of claim- Efforts should be made to settle the claims within a defined standard of 15 days.
- Service delivery should be the priority - It should be ensured that a person on the beneficiary list is not denied service if she does not have a card.