PMJAY scheme has impressive list of benefits, but 'flawed model', lack of funds have medical experts sceptical
FirstpostAccording to an expert from TISS, the low 2018-19 budget for PMJAY was the fundamental flaw with the health insurance scheme under Ayushman Bharat. Within 24 hours of Prime Minister Narendra Modi launching the Pradhan Mantri Jan Arogya Yojana, a newspaper report claimed that the initiative under the comprehensive “Ayushman Bharat” health insurance scheme had already benefited more than a 1,000 patients. Dubbed the “largest government-funded healthcare scheme” in the world, it aims to provide coverage of Rs 5 lakh per family annually and help more than 10.74 crore poor and vulnerable families — around 50 crore people — with secondary and tertiary care hospitalisation through a network of Empanelled Healthcare Providers. Dr Salvaraj admits that expanding the platform to Uttar Pradesh and Bihar — considered “bimaru states” in more ways than one — is a good step, but poor families in Tamil Nadu, Andhra Pradesh, Telangana and Maharashtra were already covered by a basic health insurance package. “Private hospitals will continue to double-charge; they will continue to levy out-of-pocket costs, much higher than what a patient would pay at a government hospital,” said Dr Sundararaman.