In Ayushman Bharat, primary and
secondary healthcare complement each other (Indian Express)
Mains Paper 2: Governance
Prelims level: Ayushman Bharat
Mains level: Ayushman Bharat implementation and impacts
Ayushman Bharat promotes secondary and tertiary care at the cost
of primary care.
The Perception of all health needs in India relate only to primary
care and there is no need to expand support for tertiary care.
The Perception of Ayushman Bharat is taking away resources from
primary care and benefiting big private hospitals.
Even if we do our best to promote good health, there will still be
a critical need for tertiary care and secondary care.
The diseases related to old age will increase even among the poor
strong primary healthcare system requires an equally strong secondary and
tertiary healthcare system.
Secondary and tertiary care in the country is largely provided by
private sector inaccessible to the poor Ayushman Bharat has changed
Ayushman Bharat has two legs.
The Pradhan Mantri Jan Arogya Yojana (PMJAY), covers more than 50
crore people in the country the poorest against serious illnesses.
To strengthen primary healthcare upgrade more than 1.5 lakh health
facilities to health and wellness Centres (HWC).
The resources spent on the PMJAY component of Ayushman Bharat are
still a very small proportion of the entire health budget.
A major portion of the health budget is spent on primary care and
secondary care, almost entirely focused on public sector supply of the
The 2017 Health Policy is increasing the health sector allocation
to 2.5 per cent of the GDP for decades, hovered at around 1 per cent of the
High level political commitment for the health sector
If this trend continues, we should be able to provide much needed
tertiary care for the poor without compromising the support for primary
States have freedom to choose the implementation model; in fact,
most states, including all the large ones (UP, Bihar, MP, AP) have decided
to use a trust model where the government directly purchases healthcare
services from the hospitals without using any insurance company.
Of the states that are using the insurance model most have
resorted to public sector insurance companies.
Finally, the scheme has a “claw-back” clause in its model
contract, which limits the margin of the insurance companies to only 15 per
cent they will have to return the government any extra margin.
This margin includes administrative expenses and therefore the
potential profit is much less than 15 per cent, while the loss for the
company could be quite high.
The scheme’s design ensures that private sector hospitals do not
unduly receive a large proportion of financial resources. The payment for
services is based on fixed package rate for each procedure, which is largely
based on the marginal cost.
The scheme also has strong features for preventing, mitigating and
deterring fraud and abuse.
Q1. Which of these are constitutional provisions?
1. Duties of prime minister to furnish required information to the president
2. Power of president to consult Supreme Court
3. Special provisions with respect to Delhi
Select the correct answer using the codes below.
a) 1 and 2 only
b) 2 only
c) 1 and 3 only
d) 1, 2 and 3
Q.1) Discuss the promises and challenges in implementation of a bold experiment
in health sector named Ayushman Bharat.