It is good and innovative, but the proof of its success lies in its implementation, constant audit, course correction if needed, and the need for scale-ups
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Ayushman Bharat, conceived to keep India’s population healthy and disease-free, is undoubtedly among the most ambitious schemes launched by the Narendra Modi government. Many experts and media, however, perceive Ayushman Bharat to be another insurance scheme, which it is not. Insurance is just a major component of the umbrella scheme. The other components are the wellness centres and rebooting the primary healthcare centres.
The misconception stems from a communication gap. Since the National Health Protection Scheme (NHPS) announced in the 2018 Union Budget got a good Press as a first of its kind, many mistook it to be the Aysuhman Bharat scheme.
Many described NHPS as the mother of all insurance schemes in the country and Ayushman Bharat got pushed to the sidelines. The NHPS is designed for over ten crore poor and vulnerable families who constitute the burgeoning base of the population pyramid. It will cover an estimated 50 crore individual beneficiaries for up to Rs 5 lakh per family per year.
A major challenge ahead for the NHPS is to get its message across to the true beneficiaries at the base of the pyramid. They are either semi-literate or illiterate. Hence, communication has to be through the vernacular media or other innovative and novel forms of well researched packaged message – both visual and non-visual.
The NHPS is part of the Universal Health Protection Scheme. In the years to come, India will be at the top as an economic power expanding its influence horizon across the globe. But any move on rapid economic growth is always and inevitably linked to better health of the population.
Unless its people are healthy and fit, India’s aspiration to sustain a high level of economic growth and become an economic superpower will be on a slow track. Experts say that one extra year of life expectancy adds four per cent to the GDP, and with every dollar/rupee spent on health, return on investment will be nine to ten times.
I had earlier referred to Ayushman Bharat as having other components, apart from insurance. The next major part is the plan to reboot the rural health centres towards preventive healthcare. Over 1.5 lakh such centres will now be recalibrated as wellness centres to bring the healthcare system closer to the homes of people. These centres will provide comprehensive healthcare, extending to non-communicable diseases, maternal and child health services. These centres will also provide free essential drugs and diagnostic services.
When all these components work in tandem, Ayushman Bharat will be truly successful. India’s vision for the health sector for the years ahead is indeed big and ambitious. But implementation will be a challenge. The Modi government is never short on ideas and slogans, but implementation has sometimes been its Achilles Heel.
At the implementation level for instance, Ayushman Bharat may burden the already overflowing government hospitals. This is where public-private participation is crucial. Public-private partnership can be achieved by making health cover possible at accredited facilities across the private and public sector. To ease the burden on hospitals, innovative and ‘big thinking’ is a must. Home healthcare is a viable option.
The government has to seriously consider facilitating partnerships with the home healthcare segment, particularly to solve the perpetual shortage of beds. Home healthcare can directly address the issue of shortage of beds, doctors and paramedical staff. Since shortage of beds is higher in Tier-II and Tier-III cities, hospitals can extend their reach with a home healthcare partnership, without building expensive infrastructure.
Ayushman Bharat is both a challenge and an opportunity. It is good and innovative, but the proof of its success lies in its implementation, constant audit, course correction if needed, and the need for scale-ups.
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