In the Union Budget for 2018, NDA government announced the world’s largest healthcare scheme, targeted to provide an annual health cover of Rs. 5 lakh per family for approximately 50 crore people. Soon after the announcement, a lot of myths about the coverage and cost of the scheme had started floating around social media, which were debunked by OpIndia.
On 23 September 2018, PM Modi formally launched the ‘Ayushman Bharat’ scheme, which provides cashless and paperless access to 1350 medical packages including surgery, diagnostics, daycare treatment and cost of medicines. The scheme also covers all pre-existing conditions, a feature which many private medical insurances do not provide.
In addition to government hospitals, the scheme has so far empanelled 14,000 hospitals on board. 10.74 crore households have been identified as the beneficiaries of Ayushman Bharat, of which 8.03 crore are rural households. Within just 10 days of the launch, Ayushman Bharat had already benefited thousands of people – an early indicator of the scheme’s necessity and success. The Deputy CEO of Ayushman Bharat announced on 21st October 2018 that 1,03,810 patients treated in Ayushman Bharat since the launch 4 weeks back.
However, the usual suspects are back with mischievous propaganda against Ayushman Bharat. The latest attempt is by Newslaundry, a serial offender in spreading half-truths and whole lies. The website recently published an article titled “NL Cheatsheet: Are you excluded from Modi’s Ayushman Bharat?”. The sub-heading of the article says “Fifty crore people are supposed to benefit from the scheme but if you even own a landline or a fridge, you’re excluded from ‘Modicare'”. The said article includes a video which talks about the inclusion and exclusion criteria for beneficiaries of Ayushman Bharat.
Below are some claims made by Newslaundry, and fact-check done by OpIndia:
NL Claim #1: Surprisingly, according to the guidelines issued, even those owning a fridge or a landline phone appear in the exclusion list.
Fact: The beneficiaries of Ayushman Bharat have been identified based on the Socio-Economic and Cast Census (SECC) conducted in 2011. While it is true that households owning a fridge and landline phone will be excluded from Ayushman Bharat, NL does not mention here that this exclusion criterion was defined in the SECC for determining the socio-economic status of households.
SECC provided for 14 automatic exclusion criteria (including owning a fridge or landline) and 5 automatic inclusion criteria for determining the level of ‘deprivation’ in rural households. So if Newslaundry had done a little research about SECC, they would have realised that there is nothing ‘surprising’ about the exclusion criteria specified in the Ayushman Bharat guidelines.
The table below summarises the findings of SECC 2011 for Rural India:
(Source – SECC Website)
The data shows that 8.73 crore households displayed at least one deprivation (D1-D7). For Ayushman Bharat, rural households belonging to D1, D2, D3, D4, D5 and D7 criteria will be eligible. According to official data, that number is 8.03 crore.
There are two important points to note here:
- Deprivation findings have been reported after applying the exclusion criteria, i.e. the 8.03 crore rural households eligible for Ayushman Bharat have already passed the exclusion criteria test of the refrigerator, motorised vehicle, etc.
- The exclusion is based on the status of households when SECC was conducted, i.e. in 2011, not today. For example, a household which owns a refrigerator today, but did not have one in 2011 will be eligible for Ayushman Bharat provided it didn’t fall under any other exclusion criteria in 2011.
NL Claim #2: If you thought that slum dwellers and rickshaw pullers in urban areas have something to celebrate about this scheme, think again. A family with even a single member earning more than ₹10,000 a month does not qualify under the Ayushman Bharat (scheme).
Fact: While the Ayushman Bharat guidelines do not explicitly mention about the applicability of exclusion criteria, a self-proclaimed ‘watchdog’ like Newslaundry didn’t bother to do basic research. SECC defined exclusion criteria for calculation of deprivation indicators for rural households only. The SECC questionnaire for urban areas did not have any question related to the monthly income of household members, which means monthly income data is not available for urban households. Thus urban households cannot be excluded/disqualified from Ayushman Bharat based on monthly income. The exclusion criteria of Rs. 10,000 monthly income is, for all practical purposes, applicable to rural households only (SECC rural questionnaire included a question on income levels).
NL Claim #3: Delhi auto-wallas can thank Chief Minister Arvind Kejriwal because Delhi has refused to sign the MoU like four other states.
Fact: Again, going by the SECC definition, the exclusion criteria has been defined only for rural households, and most of the data points related to exclusion criteria are not available for urban households. But irrespective of whether auto-wallas are excluded or not, it’s ludicrous to say that Delhi auto-wallas should thank Kejriwal for refusing to participate in Ayushman Bharat. Kejriwal’s refusal has resulted in the exclusion of not only auto-wallas but also all other eligible beneficiaries.
NL Claim #4: Households having Kisan credit cards with a credit limit above ₹50,000—which is a big chunk of small-scale farmers—don’t qualify.
Fact: As per SECC 2011, only 3.6% of rural households had Kisan Credit Cards with a credit limit of above ₹50,000. How 3.6% translates to “a big chunk of small-scale farmers” is unfathomable. Maybe Newslaundry folks studied some other type of Math which we don’t know.
NL Claim #5: A large chunk of agricultural families have 2.5 acres of irrigated land with at least one irrigation equipment. (The presenter confidently says, “note it when I say this” while making this claim).
Fact: Households having 2.5 acres of irrigated land with at least one irrigation equipment are not eligible for Ayushman Bharat. However, while reporting this, Newslaundry again displayed their inability to do basic research. The presenter confidently claims that “a large chunk” of agricultural families in India fall in this bucket. However, if NL had bothered to give a cursory look at the SECC data, they would have realised that (and NL folks should note it when we say this) only 4.5% of rural households have 2.5 acres or more of irrigated land with at least one irrigation equipment.
NL Claim #6: The obvious question everyone wants to ask you, Prime Minister Narendra Modi, is that who exactly is benefiting from the (presenter uses air quotes) “world’s biggest” health care scheme. The presenter further claims that the current eligible beneficiaries (10.74 crore households) could be excluded if they fall under any exclusion criteria.
Fact: As explained above, the list of 10.74 crore households who are eligible for Ayushman Bharat has been prepared after applying the exclusion criteria. Throughout the video, the presenter gives details of various exclusion criteria, insinuating that all those criteria would result in the large-scale exclusion of deserving households. He fails to mention anywhere in the video that the beneficiary households identified by the government have already passed the exclusion criteria test. So talking about refrigerator or landline phones is inconsequential at this stage.
It is also important to note that Ayushman Bharat was never intended to cover 100% population. From the beginning, the government has been clear that the scheme would be targeted at the 50 crore people at the bottom of the socio-economic strata. If we multiply 10.74 crore households by the average size of household (4.8), the result is 51.55 crore beneficiaries, which is consistent with the target coverage of the scheme.
Only time will tell how successful Ayushman Bharat is, but as far as the claims about the selection and inclusion/exclusion of beneficiaries is concerned, the claims by Newslaundry and other sundry commentators are unfounded.