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Ayushman Bharat; Augur III For Jharkhand

Of the total expenditure on 50 crore (from 10.74 crore families) identified economically backward class people to be covered with Rs. 5 lakh health-insurance each across the country, the State Government is supposed to bear 40 per cent of the cost

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Jharkhand that is already struggling to cope with a resource-crunch is now saddled with the sinister implication of more liabilities to be incurred on Ayushman Bharat scheme (as the Pradhan Mantri Jan Aarogya Yojana is referred to). The awry implementation of the scheme is, as such, believed to be a foregone conclusion in the State in particular.

Of the total expenditure on 50 crore (from 10.74 crore families) identified economically backward class people to be covered with Rs. 5 lakh health-insurance each across the country, the State Government is supposed to bear 40 per cent of the cost. Jharkhand has identified 57 lakh beneficiaries to be covered under the scheme, bearing an exorbitant cost.

Indeed, Jharkhand has reasons to feel elated about receiving the honour for being chosen to launch the self-styled world’s largest health-insurance scheme by none other than Prime Minister Narendra Modi from Ranchi on Sunday, but, at the same time, the State is in a fix on how to deal with the eventual financial burden. The State Government can neither afford to do away with the responsibility in the garb of financial constraints nor can it incur the liability with its present financial strength.

If well-placed sources in the State Government are to be believed, the State exchequer is supposed to incur an estimated additional expenditure of at least Rs 600 crore for the scheme. They, however, contented that claims against health-insurance are unlikely to be made over Rs. One lakh by 90 per cent of beneficiaries at a time. More, they claimed that treatment charges at hospitals enlisted under Ayushman Bharat had been kept quite inexpensive to ensure health-insurance claims low. 

Interestingly, the State Government is already carrying out a health insurance scheme of Rs 2.5 lakh coverage (in addition to the Rs 30000 more for senior citizens) for 57 lakh economically backward class people under Mukhyamantri Swasthya Bima Yojana. While the Jharkhand Government aims to mop up costs of the State-sponsored insurance scheme by mobilising 60 per cent of the share by the Central Government under Ayushman Bharat, beneficiaries are supposed to have two options to avail of their medical claims.

As per the Ayushman Bharat scheme, the State Government is supposed to claim reimbursement of 60 per cent from the Centre against the cost spent on health-insurance of the economically backward class beneficiaries. This 60 per cent is believed to be potent enough to mop up the cost of State Government-sponsored insurance scheme. At the same time, beneficiaries could well do mischief by making double claims under Ayushman Bharat and MBSY as well.  In fact, the authorities concerned in the State Government have already been expressing their concerns about financial irregularities while executing two parallel health-insurance schemes in the State. 

As per official records, the State Government is faced with the worst-ever resource crunch and mulling ways to mobilise finances for its survival. Sources revealed that amid a deficit budget of Rs. 80,200 crore for 2018-19 fiscal, various payments to the tune of about Rs. 1000 crore had to be withheld for want of adequate balance in the Government’s treasuries. The crisis is believed to have been confounded owing to the Government’s decision to exercise populist-measures at the cost of major revenue sources.

They contended that major sources of revenue included Land Revenue, Excise duties on liquor and royalties from the mining of minerals. Incidentally, the present dispensation came out with a major decision to dole out land deeds to women by reducing registry cost to Rs. 1, enforce a partial ban on selling of liquor and close down 21 iron ore mines. Besides, thousands of appointments made in different sectors have cost the Government dearly in the form of their salary payments.

The Government is believed to have suffered revenue losses of over Rs. 3000 crore from non-operation of iron-ore mines alone for the past three years. Notably, the Jharkhand Government has cancelled leases to 21 iron-ore mines in the Kolhan region of the State in the light of the recommendations of the MB Shah Commission that was constituted at the behest of the Supreme Court to probe into illegal mining of iron-ore across the country. The decision has not only dealt a blow to mining operations and employment, but it has had a major collateral impact on the functioning and employment at factories that depend largely on iron-ore for their production and the crusher industries as well. Of the total 1978 crushers -- that also include those of stone-chips -- around 500 iron-ore crushing units have consequently been shut down in the area.

Likewise, the Government has incurred a loss of about Rs. 500 crore from the partial ban on liquor business and Rs. 1000 crore from nearly free-registry of land to women.  

Indeed, while launching the scheme, the Prime Minister claimed that the scheme was meant to empower the economically-backward class that has been the victim of political intrigue by parties in power in the past, but the scheme appeared to be unrealistic in the light of the fateful consequences meted out to the Rashtriya Swasthya Bima Yojana. The past bears testimony to the fact that RSBY happened to be an ‘unexposed’ scam during the erstwhile UPA dispensation at the Centre. RSBY hospitals and clinics swindled public money by producing fake and inflated bills against treatments of beneficiaries in collusion with government officials.

Notwithstanding, the scheme is a noble one and the BJP aims to reap political benefits in particular with its launch ahead of ensuing Parliamentary and Assembly elections in different States. Significantly, the strategic time identified to launch the scheme is supposed to have been prompted by the fact that even if the execution of the scheme goes awry for want of substantial resources, beneficiaries have little time to go against the Government and vote for the opposition in the elections that are due in next a few months. The credentials of the Government for its purported demagogic role would remain untarnished as such.

To top it all, the Prime Minister was, however, articulate in getting his ‘diplomatic’ views across – while launching the much-acclaimed health-insurance scheme– that contrary to the dubious role played by erstwhile Government of opposition, he espoused the idea of ‘ Sab Ka Sath, Sab Ka Vikas’ with the contention that he would not make any discrimination on the basis of caste and creed while serving the people with welfare schemes. 

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