Ayushmaan Bharat programme announced in the union budget 2018-19 is a potential game changer for the Indian healthcare system. It has placed health irreversibly on the higher political agenda and public discussion. The newly proposed National Health Protection Scheme will target the vulnerable and deprived population to provide accessibility and affordability for the health-related issues. The government has recently changed the name of the scheme from Ayushmaan Bharat to Pradhan Mantri Jan Arogya Abhiyaan.
Ayushmaan means ‘blessed with a long life’. This is the largest healthcare scheme in the world and will be fully financed by the government. This scheme will provide a health insurance cover of up to 5 lakh per family per year for the secondary and territory care institutions. The State governments will be free to implement this scheme through the insurance model or trust model. The National Health Protection Scheme will replace the existing Rashtriya Swasthya Bima Yojana (RSBY).
Ayushmaan Bharat scheme has two major components. The first is the Health and Wellness Centers (HWCs) which aims for providing comprehensive primary health care services closer to the community. The Second component is National Health protection Scheme or NHPS which aims to provide financial protection of up to 5 lakh rupees per family per annum to about 10 crore vulnerable families for the secondary and territory care hospitalization related expenditure.
Proposed design and implementation plan for NHPS
- The ‘deprived data’ from socio-economic caste census (SECC) of 2011 will be used for eligibility of beneficiaries.
- The enrollment and identification will be will be linked with Aadhar number.
- A premium of Rupees 1,082 per family has been estimated under NHPS-2018.
- The government will pay the entire premium for targeted beneficiaries, with no contribution by the beneficiaries.
- The full-scale implementation of NHPS (for 10 crore families) will cost about 12,000 crore rupees per annum to the government including administrative and other costs.
- The premium will be shared between central and state governments, at 60-40, 80-20 or 90-10 formula, as applicable for other centrally sponsored schemes.
- The State governments will be free to choose between insurance or trust model to implement the scheme.
- Indu Bhushan is appointed as the CEO of Ayushmaan Bharat Scheme by the Government.