Is Ayushman Bharat Effective Enough to Provide Quality Healthcare?

The Indian healthcare sector is currently in a state of epidemiological transition, owing to the increasing rise of communicable and non-communicable diseases. As a result, there remains a continued threat to the health and economic security of the public and particularly the poor and deprived rural population are at a stake. So, it is necessary for the healthcare sector to confront the emerging problems of high cost, unaffordability, and inaccessibility of quality healthcare and make ways to manage the financial risks without out-of-the-pocket expenditure. This is where the role of health insurance comes. A well-planned insurance policy would be of great assistance to a major section of the disadvantaged population in uplifting their quality of life and access to healthcare.

To address the existing challenges, the government of India has unveiled a government-funded healthcare programme called Ayushman Bharat or the National Health Protection Scheme (NHPS). The Ayushman Bharat Healthcare scheme is touted as the world's largest healthcare program that would provide health insurance coverage to approximately 50 crore Indians. As per the scheme announced by Prime Minister Narendra Modi, it covers over 10 crore families across the country, giving them an insurance cover of INR 5 lakh per family per year. The scheme covers both secondary and tertiary healthcare, focusing on acute hospital care with no initial payment/deposit required for claims.

The primary objective of the scheme is to bring healthcare benefits to the poor and deprived residing in rural and urban areas across the country. The existing healthcare costs and lack of a proper healthcare system in the rural areas of India has increased the mortality rates in these regions but this scheme is expected to bring a change to people in these demographics.

The scheme aims to target the poor and disadvantaged rural families and some of whom are identified from the occupational category of urban workers. As a flagship scheme, it would likely benefit more than 37 percent of the total population, nearly covering all the poor and vulnerable families. The government has planned to invest around INR 12000 crores for the implementation of this scheme with a cost shared between central and state governments on a 60:40 basis. Moreover, the government will set up or convert around 150,000 sub-centers in the country as ‘health & wellness’ centers, offering healthcare services including maternal and child health services, vaccinations, mental health services, screening for several NCDs, and even some cancers. All the sub-centers will be manned by two paramedical staff, catering to a population of about 5000 people each.

The Ayushman Bharat is apparently driven to strengthen the primary healthcare of socially and economically backward people and offer them the financial protection from catastrophic health expenditures. The scheme is expected to be immensely beneficial for all the poor families, both urban and rural, and help them avail healthcare benefits without any out-of-the-pocket expenditure.

However, for the scheme to succeed in the Indian healthcare ecosystem, implementation is the key. The Ayushman Bharat scheme, if implemented properly, would bring a striking change to the current scenario by enhancing healthcare access to a larger section of society who couldn’t otherwise afford them. The scheme includes early detection of diseases and treatment services offered by government healthcare centers and other empanelled hospitals. The beneficiaries for Ayushman Bharat are identified by linking their Aadhar and the services received can be followed up to analyze or track the health outcomes. The scheme makes it easier for the government and the public health authorities to monitor healthcare outcomes and evaluate the impact of the program across the country.

In addition to that, a continuum of healthcare system is established by linking healthcare institutions or hospitals in a particular region with that of the public health centers and the regional community. This will help increase community engagement within the locality, thus helping in the initial stage planning and implementation of the program. Moreover, proper implementation and evaluation of the program can help ensure that the primary health and wellness centers within the regions are responsive to the immediate needs of the community.

To make the implementation process successful, the  has set up an independent body within the ministry of health & family welfare so that they can help in planning, coordinating, and providing technical backstopping to center and the states including the infrastructure development and capacity building for the programme. The independent unit will ensure that there is a uniform and systematic approach to implementing the program across the entire country.

Overall, the Ayushman Bharat scheme is a forward-thinking and path-breaking concept in the history of public health in India. The program is sure to gain a transformative impact in the Indian healthcare ecosystem but that would happen only and only if the scheme is implemented effectively in a coordinated manner. The goal is to realize the country’s healthcare demands, affordability, and accessibility of care among all sections of the population and pave the way to build a healthy generation along with a strong, prosperous nation.