News Life and Health25 Sep 2018

India:World's biggest healthcare scheme launched

25 Sep 2018

Indian Prime Minister Narendra Modi has launched the world's biggest healthcare programme Pradhan Mantri Jan Aarogya Yojana that aims to provide free healt

The scheme, which the government dubs "Modicare", will give 100m families - or about 500m poor people - INR500,000 ($6,866) in health cover each year for free treatment of serious ailments.

The measures are Mr Modi's latest attempt to reform a public health system that faces a shortage of hospitals and doctors. The government has also, in recent years, capped prices of critical drugs and medical devices, and increased healthcare funding.

Thirty states and union territories have signed up for the ambitious health insurance scheme out of a total of 36. Delhi, Odisha and Kerala are among those yet to join.

Ahead of the grand rollout, doubts remain about both the idea and the implementation of this large-scale health insurance programme and there are several loose ends that the government needs to tie up, reports

The broader health scheme includes plans to open 150,000 Health and Wellness Centres that will essentially be upgraded versions of existing health sub-centres, which are the first point of contact in the public healthcare system in India, located in the country’s remotest areas. The second dimension is the Pradhan Mantri Jan Aarogya Yojana which is planned to cover more than 1,300 medical treatments and procedures.

Since the announcement in February of the proposed health insurance scheme, the government has pulled out all stops to get the programme off the ground.

Officials at government think-tank Niti Aayog and the National Health Agency, which is the implementing authority for the scheme, say that 8,000 hospitals have offered to join the network of health facilities to be empanelled to provide treatment and services under the scheme. The government has also set up a website and helplines for beneficiaries, while hospitals have been directed to set up information kiosks.

First claim

The first claims under Pradhan Mantri Jan Aarogya Yojana have already been disbursed. The family of a girl who was born on 15 August in Haryana where the project had been launched on pilot basis in a few hospitals. The government hospital where the mother had her C-section was given INR9,000, the rate for deliveries under the scheme.

Despite this progress, not all systems seem to be in place. For one, the programme has not yet specified standard operating procedures for doctors or the various treatments, sources told Business Standard.

The Socio Economic Caste Census, 2011, forms the basis of enrolment for the exercise. Families that were listed as deprived under the census are eligible under the scheme. As a result, in some cases, those who were excluded from the census have also been left out from the Pradhan Mantri Jan Aarogya Yojana, even if they meet other criteria, the publication said.

Concerns also remain about the implementation of a scheme of this scale.


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