Ayushman Bharat Yojana

Ayushman Bharat Yojana
Ayushman Bharat logo.png
CountryIndia
Prime Minister(s)Narendra Modi
Launched23 September 2018; 14 months ago (2018-09-23)
StatusActive
Websitehttps://www.pmjay.gov.in/

Ayushman Bharat Yojana or Pradhan Mantri Jan Arogya Yojana (PMJAY) or National Health Protection Scheme[1] is a national scheme that aimed at making necessary interventions in primary, secondary and tertiary health-care systems,in a holistic fashion.[2] It was launched in 2018, under the aegis of Ministry of Health and Family Welfare in India.

History[edit]

The National Health Protection Scheme (NHPS) scheme is formed by subsuming multiple schemes including Rashtriya Swasthya Bima Yojana, Senior citizen health Insurance Scheme (SCHIS), Central Government Health Scheme (CGHS), Employees' State Insurance Scheme (ESIS), etc. The National Health Policy, 2017 has envisioned Health and Wellness Centres as the foundation of India’s health system which the scheme aims to establish.[3]

The Central Government Health Scheme (CGHS) was started under the Indian Ministry of Health and Family Welfare in 1954 with the objective of providing comprehensive medical care facilities to Central Government employees, pensioners and their dependents residing in CGHS covered cities. This health scheme is now in operation with cities such as Bhubaneswar, Bhopal, Chandigarh, and Bangalore. The dispensary is the backbone of the Scheme. Instructions on these various matters have been issued from, time to time for the guidance of specialists and medical Officers. The Central Government Health Scheme offers health services through Allopathic and Homeopathic systems as well as through traditional Indian forms of medicine such as Ayurveda, Unani, Yoga and Siddha.[4]

Reach[edit]

26 states and union territories accepted the scheme, except four states: Delhi, Odisha, West Bengal and Telangana.[5] More than a lakh (100,000) people have taken benefit of the scheme till October 2018.[6] By 26th November more than 825,000 e-cards were generated and there was a push to recruit private hospitals to the scheme.[7]

Controversies[edit]

The scheme has been subject to significant criticism, from multiple aspects.[8]

There have been media reports of widespread misuse of the Ayushman Bharat scheme by unscrupulous private hospitals through submission of fake medical bills. Under the Scheme, surgeries have been claimed to be performed on persons who had been discharged long ago and dialysis has been shown as performed at hospitals not having kidney transplant facility.[9] There are at least 697 fake cases in Uttarakhand State alone, where fine of Rs one crore has been imposed on hospitals for frauds under the Scheme.[10] However, unlike the earlier RSBY (Rashtriya Swasthya Bima Yojana) era, plagued by lax monitoring of insurance fraud, AB-PMJAY involves a robust information technology infrastructure overseeing transactions and locating suspicious surges across the country. Many hospitals have been blacklisted and the constantly evolving fraud-control system will play a major role in streamlining the scheme as it matures. Initial analysis of high-value claims under PMJAY has revealed that a relatively small number of districts and hospitals account for a high number of these, and some hint of an anti-women bias, with male patients getting more coverage. Despite all efforts to curb foul-play, the risk of unscrupulous private entities profiteering from gaming the system is clearly present in AB-PMJAY.[11]

References[edit]