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Rushing through “Ayushman Bharat”

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August 15, 2018

What is the issue?

  • The proposed “Ayushman Bharat - National Health Protection Mission” might soon see a formal announcement.
  • But little preparation seems to have gone into it thus far.

What is the current state of the scheme?

  • At least six states are said to be ready to roll out a pilot of the new health care scheme, but there is little clarity on the details.
  • It was earlier assumed that the scheme would be an insurance-based mechanism, but there are indications to the contrary now.
  • Government seems to have envisioned a greater administrative role in the proposed scheme through public-private partnership. 
  • If so, this is a positive as it will provide welcome flexibility in the initial stages, and allow for experimentation across different designs.
  • Currently, the only thing clear about the scheme is that it would provide a health cover of up to “5 lakh per annum” to about 1o crore poor families.
  • But the beneficiary lists have not been prepared yet and the overall implementation seems to be rushed through by the government.
  • The realisation that a scheme with such a large scope cannot be properly implemented without adequate preparation is needed.

What are the shortfalls in preparation?

  • A scheme for expanding access in tertiary health care cannot work without significantly widening the supply of hospital beds and specialist doctors.
  • This has not occurred thus far and there is a massive shortage in the supply of services — trained staff, hospitals and diagnostic centres.
  • The deficit in doctors is particularly wide, with India being at least 75% short of the number of qualified doctors it needs.
  • While the funds allocated to the scheme might generate a demand, it would be naive to assume that it would automatically generate its own supply.
  • Implementing the scheme now would cause an unplanned erratic expansion and the associated bottlenecks and inefficiencies.
  • Hence, the government must explain how it intends to fill the infrastructure deficit alongside the phased roll-out of Ayushman Bharat.
  • Further, if the government intends to have a properly working health system, it should ensure that primary healthcare apparatus is properly structured.
  • Notably, most Primary and community health care centres are understaffed, under-funded, under-trained and under-equipped.

 

Source: Business Standard

 

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