THE GIST of Editorial for UPSC Exams : 25 September 2018 (Long road ahead: on Ayushman Bharat scheme)

Long road ahead: on Ayushman Bharat scheme 

Long road ahead: on Ayushman Bharat scheme 
Mains Paper: 2 | Health 
Prelims level: Ayushman Bharat scheme 
Mains level: Budgetary support must be strengthened to make Ayushman Bharat a success 

Introduction 

• Ayushman Bharat has been rolled out as a health protection scheme that will provide guaranteed access to treatment that is free at the point of delivery to about 40% of the population selected on the basis of censused socio-economic indicators. 
• It is the essential first step on the road to universal health coverage, although it has been launched by the NDA government quite late in its term, possibly with an eye on the 2019 general election.
• Since the Centre has announced that 10.74 crore families identified through Socio-Economic Caste Census data will be given an annual ₹5 lakh cover under the Pradhan Mantri Jan Arogya Yojana (the insurance component of the scheme).

To what extent it is  possible to implement

• The allocation of just ₹2,000 crore during the current year to the PMJAY cannot provide the promised cover to the large population sought to be included. 
• Not all States and Union Territories are in a position to raise their own share, and a few have not even joined the scheme. 
• The challenge of funding, therefore, remains and without adequate budgetary commitments, the implications of pooling the financial risk for such a large segment of the population through insurers or state-run trusts or societies make the outcomes uncertain.

The Prime objectives of PMJAY

• Guaranteeing health-care access using private or public facilities presumes tight cost control. In the case of the PMJAY, this is to be achieved using defined treatment packages for which rates are prescribed.
• Costs are a contested area between the care-providers and the Centre, and many for-profit hospitals see the government’s proposals as unviable. 
• The Ayushman Bharat administration is talking of a rate review.
• More importantly, a lot of time has been lost in the NDA government’s tenure, when State governments should have been persuaded to regulate the hospital sector under the Clinical Establishments (Registration and Regulation) Act, which dates back to 2010. 
• The law broadly provides for standardisation of facilities and reasonable rates for procedures. 
• The apprehensions of fraud have prompted Ayushman Bharat administrators to announce that some key treatments should be availed through public sector institutions.
• It is essential to reduce the pressure on secondary and tertiary hospitals for expensive treatments by investing in preventive and primary care facilities. 
• The 150,000 health and wellness centres of the National Health Protection Mission can play a valuable role. 
• The first-order priority should be to draw up a road map for universal health coverage, through continuous upgradation of the public sector infrastructure.

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General Studies Pre. Cum Mains Study Materials

UPSC Prelims Questions: 

Q.1)  Ayushman Bharat Programme is related to which of the following?
(a) Child Nutrition
(b) Healthcare and Insurance
(c) Women empowerment
(d) Environment safety
Answer:  B

UPSC Mains Questions:
Q.1)  There is a need budgetary support must be strengthened to make Ayushman Bharat a success. Critically examine the statement.