A baby girl Alia from Ranchi suffering from a critical heart disease, an 80-year-old lady from Panipat with a severely septic wound, a 59-year-old tea vendor from Aurangabad in Bihar diagnosed with oral cancer, a 60 year old tailor from Satara in Maharashtra admitted with chest pain and a youngster Devilal Nayak from Jharkhand with a broken hip – what do they all have in common? All of them have been treated free of cost (otherwise costing lakhs of rupees) at the best government or private hospitals under the Pradhan Mantri Jan Arogya Yojana (PM-JAY), more commonly known as the Ayushman Bharat Yojana and in its recently anglicized avatar – Modicare.
Not just the five people mentioned above, but 13,37,267 people (as of 28th February 2019) have been the beneficiaries of this far-reaching healthcare reform. Through this one scheme, the Modi Government has single-handedly transformed the face of primary, secondary and tertiary healthcare across the country. So much so that, the pioneering healthcare initiative of the Prime Minister has received significant praise from prominent international figures like Bill Gates and the Director General of the World Health Organization.
Being a doctor myself, I am an eyewitness to the immense challenges faced by people on the healthcare front on a daily basis. It was a matter of grave concern the healthcare sector continues to be characterized by high out-of-pocket expenditure, low financial protection and low health insurance coverage amongst both rural and urban population. According to government figures, 62.58% of our people pay for their own health and hospitalization expenses and are not covered through any form of health protection. In addition to using their income and savings, people borrow money or sell their assets to meet their healthcare needs.
The massive increase in healthcare costs over the last 15 years was completely ignored by successive UPA governments and has nearly crippled millions of households. The nation was thirsting for a concrete solution from the Modi Government to fulfil their fundamental Right to Health. As a Prime Minister of the poor, Shri Narendra Modi understood this pain and demonstrated how a government should fulfil the basic aspirations of people. To reduce the financial burden on poor and vulnerable groups arising out of catastrophic hospital visits and ensure their access to quality health services, the Modi Government conceived the momentous Ayushman Bharat scheme. It seeks to accelerate India’s progress towards achievement of Universal Health Coverage (UHC); and all the targets of United Nations Sustainable Development Goal – 3 (SDG3).
Through Ayushman Bharat, the Modi Government aims to provide financial protection (Swasthya Suraksha) to 10.74 crores poor, deprived rural families and identified occupational categories of urban workers’ families (approx. 50 crore beneficiaries). The number of beneficiaries is almost equal to the population of Canada, Mexico and the US taken together. The pace of implementation by the Modi Government has been particularly impressive as nearly one-fifth of beneficiary families (2.05 crore) have already been given e-cards under the scheme, which offers a benefit cover of Rs. 5,00,000 per family per year. It covers medical and hospitalization expenses for almost all secondary care and most of the tertiary care procedures.
The Ayushman Bharat scheme as conceptualized by the Modi Government is so overarching that it has defined 1,350 medical packages covering surgery, medical and daycare treatments including medicines, diagnostics and transport. Furthermore, to ensure that nobody is left out (especially the girl child, women, children and elderly), there is no cap on family size and age in the Mission. Keeping in line with the Prime Minister’s vision of Digital India within the healthcare sector, the scheme is cashless & paperless at the 14,708 public hospitals and empanelled private hospitals. The number of hospitals is widely expected to touch over one lakh within the next few months. When fully implemented by 2022, it will become the world’s largest government-funded health protection mission.
Such a historic scheme of epic proportions by the Modi Government is bound to receive its share of criticisms. Some of the arguments against this programme has been that it concentrates heavily only on the financing aspect and not on healthcare. However, this is far from the truth. A vital part of the Ayushman Bharat scheme is that the Modi Government is setting up 1.5 lakh health and wellness centres (HWCs) and expanding the number of Jan Aushadhi stores across the country which can prove a real game changer to the manner in which people access public health.
While the entire country considers this transformational mission of the Modi Government as a lifeline, there continue to be some elements who have decided to play petty politics over the health of citizens. The Ayushman Bharat scheme in our state of Delhi has become the major casualty of the callous attitude of our Chief Minister Arvind Kejriwal. One of the key reasons for the Delhi Government to delay implementing the scheme is the shocking demand by the Chief Minister to rename it after his party as –Mukhya Mantri Aam Aadmi Swasthya Bima Yojana Ayushman Bharat’. The Centre is said to have written back to the state government six months ago saying it was critical that the name of the scheme starts with ‘Ayushman Bharat’ since it was a “national scheme with national character” and that the state government could have any suffix after ‘Ayushman Bharat’. The Delhi government has failed to act ever since.
This appalling situation was dealt with a statesman-like approach by the Prime Minister. The Centre has empanelled three prominent central government hospitals in Delhi – AIIMS, Safdarjung Hospital and Ram Manohar Lohia Hospital – under Ayushman Bharat by entering into separate MoUs with them. To circumvent the lackadaisical and dramatic attitude of the Delhi government, the Centre has also empanelled 13 private hospitals in Delhi under the scheme by signing MoUs with them directly. It has held meetings with representatives from 45 leading private hospitals in Delhi including Apollo, Fortis and Max who are part of the National Accreditation Board for Hospitals and Healthcare Providers (NABH), to motivate them to join the scheme as well. However, the Delhi Government hospitals continue to remain elusive.
When such serious and unconditional efforts are being made by the Modi Government to implement the world’s largest government-sponsored health protection mission, the question we need to really ask ourselves is – whether the ego of one person should be greater than the health of two crore citizens of Delhi?
Dr. Nandini Sharma is a Delhi based doctor who has been running a free dispensary since 1992. Apart from social work, she is actively involved in politics and is a member of Delhi Pradesh BJP Executive Committee.