Prime Minister Narendra Modi, on October 29, rolled out a health cover scheme for all aged 70 years and above. This launch was an expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). According to the new extension, all senior citizens are expected to receive Rs.5 lakh annual coverage, per family. About six crore people from 4.5 lakh families are to benefit from this scheme, irrespective of their income.
Even though the scheme was a policy decision by the government, the Prime Minister took a dig at two opposition-ruled states, West Bengal and Delhi, as they decided to opt out of the scheme. These two states will not roll out this extension of AB PM-JAY. However, analysis done by a daily newspaper The Indian Express shows that about 45% of hospitalisations carried out under the scheme were from opposition-ruled states: Tamil Nadu, Karnataka, Kerala, Punjab, Jharkhand, Himachal Pradesh, and Telangana.
“I apologise to the people over 70 years from Delhi and West Bengal that I will not be able to serve you. I apologise because- I will come to you know that you are suffering. I will get the information, but I will not be able to help you. The reason is that the Delhi and West Bengal governments are not joining the Ayushman Bharat scheme. I’m prevented from serving older people of Delhi and West Bengal. Because of politics. I am painted”, said the prime minister.
What is the Scheme About?
While addressing an event at ‘Ayurveda Day’ in Delhi, the prime minister of India launched the senior citizen extension to the AB PM-JAY scheme. The extension aims to significantly reduce out-of-pocket expenses for low-income households. This extension of AB PM-JAY, only for senior citizens, will open the door to essential medical treatment and emergency care that were earlier unfordable. Earlier AB PM-JAY was income-based, providing Rs.5 Lakh to all eligible families. But under the expanded scheme, all 70+ will get an additional top-up cover of Rs. 5 lakh per year for themselves. Politically too, the impact of this extension will be visible more in the marginalised sections and therefore will garner trust for the Modi government.
Health is a primary union government subject and therefore this scheme is an important decision by the Modi government. As per the expanded scheme, all eligible beneficiaries will be issued an Ayushmann Vaya Vandana card. Simultaneously, a separate portal to register the elderly will be functional by Tuesday. Now, all beneficiaries can register at the nearest Ayushmann Kendra or can even do the process online via the Ayushmann NHA app.
Other than the expansion of the health scheme, the Prime Minister also launched the U-WIN portal. The portal will digitally manage vaccination, tracking two vaccines for pregnant women and 11 vaccines for children.
The Scheme in Different States
Data from the Union Health Ministry on funds spent on the health scheme by different states highlight how required financial relief was provided to families who could otherwise not afford any specialised treatment. For example, in Tamil Nadu, the funds were diverted towards general surgery, paediatric medicine and general medicine. In the state of Karnataka, the majority of the same funds were used in cardiology, cardio and vascular surgery and neurosurgery. While in the northern states of Punjab, funds were diverted mostly towards orthopaedics, general surgery and cardiology. The state of Jharkhand concentrated its funds towards ophthalmology, general surgery and general medicine.
The funds used by the scheme vary as per different states. This is because there is a highly differential healthcare need across all the states of India and the scheme is flexible to adjust.
However, in West Bengal, the already rolled out ‘Swastha Saathi’ state health scheme makes the Centre’s AB PM-JAY an unnecessary policy intervention. This state scheme gives Rs. 5 Lakh health insurance cover a year and has currently enrolled approximately 2.4. crore families. For this reason, the state has decided to push itself out of the AB PM-JAY. However, it could not do that peacefully without achieving backlash from the Prime Minister of the country.
The AB PM-JAY is an important scheme beyond political battles and electoral lip service. It is a mega health scheme in India that has the potential to create a difference. Alongside, it also aims to make healthcare more affordable, which currently cannot be taken up by the poor.
