DNA Edit: Sickness & Health – Ayushman Bharat is a game-changer

The launch of Pradhan Mantri Jan Arogya Yojana (PMJAY)-Ayushman Bharat- has given a major fillip to Prime Minister Narendra Modi’s vision for inclusive development, Sabka Saath, Sabka Vikas. For one, it will not discriminate against people on the basis of religion, caste and creed. Secondly, it comes as a huge blessing for 10.74 crore impoverished Indians who cannot afford to undergo treatment in hospitals, given the exorbitant healthcare costs. If implemented effectively, this can be the mother of all welfare schemes in India, if not the world, because it covers 1,300 ailments, including heart diseases, kidney ailments and diabetes. 

Sample this: Data of the National Sample Survey Organization (NSSO) revealed that around 86 per cent of the rural population and 82 per cent of the urban population were not covered under any scheme of health expenditure support. The same survey had also revealed that rural families primarily depended on their ‘household income/savings’ (68 per cent) and on ‘borrowings’ (25 per cent), while the urban households relied much more on their ‘income/saving’ (75 per cent) for financing expenditure on hospitalisation, than on ‘borrowings’ (only 18 per cent). If medical treatment consumes such huge proportions of a family’s earnings and savings, and also forces it to borrow, it shows why the poor will think thrice before going to a doctor. The reality is healthcare expenditure has reduced lakhs of families to penury. 

According to a study published in the British Medical Journal, in 2011-12, out of pocket expenditure for medicines pushed about 3.8 crore persons into poverty, of the 5.5 crore that were impoverished due to total health costs, including lab tests, diagnostics, doctor and surgeon fees. It is in this context that PMJAY assumes significance. According to the Socio-Economic Caste Census (SECC) 2011 data, 8.03 crore families in rural and 2.33 crore in urban areas will be entitled to be covered under this scheme, which means around 50 crore people will be entitled to the benefits. A lifeline for such a huge number of people is virtually unheard of and each family gets a benefit cover of Rs 5 lakh for secondary and tertiary care treatment involving hospitalisation. 

However, the government has an extremely tough challenge at hand: to revamp India’s public healthcare system. A study by Lancet revealed that some 2.4 million Indians die of treatable conditions every year. This shows that access to healthcare is as important as the quality of healthcare. Without ensuring a minimum level of quality, the scheme runs the risk of falling flat. Before the rolling out of the scheme, India was spending about one per cent of its GDP on healthcare, which is grossly inadequate. 

Systemic inadequacies have been plaguing public healthcare for years. With primary healthcare in shambles, most hospitals already overburdened with secondary and tertiary treatment are forced to bear additional responsibilities. One can expect only half-hearted participation from private players who are primarily guided by profit-driven motives. The Modi government has taken on a gargantuan responsibility. And, it can transform India at one stroke if Ayushman Bharat becomes a genuine success.