5 challenges with Ayushman Bharat
The government’s flagship scheme National Health Protection scheme or Ayushman Bharat may face many challenges. The scheme works very well on papers and is heavy in political content, however, its implementation to the last mile will prove of its success or failure.
The government’s calculation of premium for Ayushman Bharat
As per the Neeti Aayog officials, the premium for NHPS services comes out to be around Rs. 1000-1200 and funds have been allocated based on the calculation of this premium. Now, a simple search on Internet can show that a similar health care insurance for a small family of 3 will definitely cost upwards of Rs. 5000 minimum, based on different variable conditions. The government has reached this estimate based on its experience with previous years’ premium calculation of Rashtriya Bima Yojna, a scheme for BPL workers.
Participation of States
The government proposed a 40% participation of states in contributing towards premium and implementation of Ayushman Bharat. However, till date, there has been no communication to states and it’s very much possible that states which are not governed by ruling party may not be on board. Besides some of the states might already be having similar schemes implemented. For example, Karnataka government has plans to roll out Universal Health Coverage (UHC) which intend to provide health coverage of approximate Rs. 1.5 Lacs to 1.4 crore households living in BPL category. This cashless facility can be availed in Public and Private Hospitals both.
Additional coverage provided is expected to increase demand for healthcare service. This, in turn, is going to increase patients in private as well as public hospitals. However, most of the hospitals especially in remote areas do not have infrastructure and resources to respond. The government has made a provision to increase resources for medical services by creating bridge course to start becoming a medical practitioner, however, this is pending with the standing committee in parliament and it will take time for such practitioners to become operative.
Low participation from the private sector
Private hospitals may try to exclude themselves from accepting the health coverage provided by the government in Ayushman Bharat scheme. The government employees already enjoy a lot of such benefits already, and private hospitals providing medicare for such benefits are not very happy due to delays in payments or followup needed to be done with government machinery. Not only that, it’s also possible that some people can get into profiteering with the help of some corrupt practitioners.
Lessons learned from previous schemes
In the previous budget, the government has tried to implement a similar scheme for BPL families to provide them coverage of 1Lac rupees. However, the scheme has not been very successful in reaching out to the intended section of the society yet.