Four years of Modi govt: Ayushman Bharat a game changer?
The Modi government’s health-for-all scheme finally took shape in the fourth year of its rule with the announcement of the Ayushman Bharat programme, which assures a health insurance cover of up to Rs 5 lakh per family per year to 500 million poor and vulnerable persons.
Once it takes off, Ayushman Bharat will be the world’s largest public-funded health insurance programme, and if implemented successfully, would be the biggest achievement of the Modi government across sectors.
“It will make treatment affordable and accessible for poor as it covers practically everything in secondary and tertiary care. Close to 40% of our population will have access to hospitalisation after this scheme is implemented,” said Dr VK Paul, member, Niti Ayog.
“Each year, 7-8 million people, who are not poor, become poor because of expenses incurred during medical treatment. This scheme will change that,” he said. While the financing model is partly dependant on the states, and the scheme will subsume all existing public health insurance schemes, its effectiveness and reach will depend on the availability of quality healthcare services, which varies widely across states. To meet the shortage of doctors, nurses and other trained health professionals, the NDA announced the setting up of 14 new All India Institute of Medical Sciences (AIIMS) institutes since 2014 even though as many as six AIIMS announced by the previous government are going through severe birthing pangs because of a shortage of faculty and medical staff. “New AIIMS don’t seem at all productive as they lack staff; it is more of a grand plan rather than serving any utility,” says Dr K Srinath Reddy, founder, public health foundation of India. Muddying the water is the National Health Policy 2017. “There is lack of clarity in the policy, especially when it comes to describing strategic partnerships with the private sector. The problem with this government is that most of their initiatives have been marred by delays,” says Dr Reddy.
“There is a direction towards health overall but with considerable delays. Reforms in medical education in the form of National Medical Commission (NMC) Bill have come in almost the fifth year. The delay has reduced their impact considerably,” said Dr Reddy.
Child immunization has gone up, to about 80% from 65% in 2013, with the number of diseases for which vaccines are being given free under the universal immunisation programme going up from six to 12. The goal is to reach 90% full immunization coverage by December 2018.
“The shortcomings can’t go overnight, but with this government, health has taken centre stage. It can now only get better from here,” said Dr Paul.