8th March 2022 (5 Topics)
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How effective has Andhra Pradesh’s Aarogyasri Scheme been
Context
Andhra Pradesh’s Aarogyasri scheme.
About
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.
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