How effective has Andhra Pradesh’s Aarogyasri Scheme been

Andhra Pradesh’s Aarogyasri scheme.

About Aarogyasri scheme:

• The Aarogyasri scheme is a unique health scheme implemented by the State Government of Andhra Pradesh (AP).
• The Aarogyasri scheme was started in
• This scheme provides financial assistance to the Below Poverty Line (BPL) families for meeting their catastrophic health needs.
• To achieve universal health coverage for the BPL families in terms of access to adequate health care and financial protection, the government of AP is implementing the state-sponsored Aarogyasri Health Insurance Scheme.
• The Aarogyasri scheme aims to provide good quality health care services in the state and assist poor families with expensive health expenditure.
• It is a Public-Private Partnership (PPP) model in the field of Health Insurance custom made to the health needs of poor patients.
• This scheme provides end-to-end cashless services for the specified diseases under secondary and tertiary care through a network of service providers from the government and private sector.
• The Aarogyasri scheme is designed to benefit out-patient consultation and primary care through free screening in the health camps and the network hospitals that are a part of this scheme implementation.
• This scheme is unique in its applicability since no other state or government agency has provided universal health coverage to the poor. 
• The Information, Education and Communication (IEC) activity during the health camps, counselling, screening and treatment of common ailments in the health camps and out-patient services in the network hospitals is supplementing the government health care system in the primary and preventive care. 

Objective of Aarogyasri:

• To provide equity of access and free quality hospital care to the BPL families by purchasing quality medical services through a self-funded reimbursement mechanism from the identified network of health care providers.
• To give financial security against catastrophic health expenditure.
• To strengthen the government hospitals through demand-side financing.
• To provide universal coverage of health for both rural and urban poor of Andhra Pradesh.

Shortcomings:
Aarogyasri has been lauded for some of the benefits it provides such as for tertiary and secondary care. But it also has a number of shortcomings.

• Primary care:
  • Primary care has to be available within a kilometre from the patients’ homes.
  • For this, sub-centres and wellness centres should have MBBS doctors with basic infrastructure. This is not well addressed by the insurance model.
• Ayushman Bharat Scheme:
  • The centrally sponsored Ayushman Bharat (PM-JAY Pradhan Mantri- Jan Aarogya Yojana) is being implemented by the National Health Agency and government of Andhra Pradesh by entering into a memorandum of understanding to implement the central scheme.
  • The expenses are shared in the ratio of 60:40 between the Centre and states as is the norm in all schemes.
  • Though AP has fared better compared to others in allocation to healthcare, it has failed its doctors.
  • The UGC pay scales were due to them from 2016.
• Hospital woes 
  • A cross-section of empanelled hospitals made it clear that the dues to hospitals from the government were piling up.