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PM- Ayushman Yojana
Context:
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has authorised 7.8 crore hospital admissions over six years, saving millions of lives and preventing impoverishment due to healthcare costs.
About the Scheme:
- Comprehensive Healthcare Coverage: The scheme offers free healthcare up to ₹5 lakh per beneficiary family(10 crore family) annually for secondary and tertiary treatment, covering nearly all inpatient care needs of families.
- Access to Public and Private Hospitals: PMJAY connects 29,000 empanelled hospitals (13,000 in the private sector), with a majority of admissions (57%) happening in private hospitals, especially in Tier-2 and Tier-3 cities.
Extended Coverage: Recent expansions include coverage for 37 lakh ASHA and Anganwadi workers and extending coverage to all citizens aged 70+ regardless of socioeconomic status.
Components of the Scheme:
- Health and Wellness Centers (HWCs)
- Objective: Provide comprehensive primary healthcare, focusing on preventive, promotive, and curative care.
- Infrastructure: Establishment of 1.75 lakh HWCs to enhance access to quality healthcare.
- Pradhan Mantri Jan Arogya Yojana (PM-JAY)
- Objective: Offer health insurance to economically vulnerable families for secondary and tertiary care.
Significance of the scheme:
- Public Welfare andEconomic Impact: PMJAY has lessened the vulnerability of the bottom 50% of India’s population to medical expenditure shocks and is seen as a cornerstone in building a healthy and prosperous “Viksit Bharat.”
- Improved Public Healthcare Infrastructure: Public hospitals have enhanced their infrastructure and amenities using funds reimbursed under the scheme.
- Reducing Out-of-Pocket Expenditure
- Support for the Elderly: The scheme benefits 6 crore senior citizens, addressing the high hospitalisation rate among the elderly, especially women.
Challenges in Implementation
- Human Resources: Ensuring adequate, skilled, and equipped personnel at Primary Health Centers.
- Infrastructure Development & Financial Allocation
- Supply Chain Management: Enhancing the supply chain for the availability of free essential drugs and diagnostics for Comprehensive Primary Healthcare services.
- Community Engagement: Developing proven community outreach strategies to promote ownership and awareness of healthy lifestyles among the community.
- Limited Coverage for Outpatient Services
- Regional Variations in Service Availability e.g. Urban and Rural.
Way Forward:
- The Pradhan Mantri Jan Arogya Yojana (PMJAY) primarily covers inpatient secondary and tertiary care, excluding outpatient services.
- To address outpatient needs, over 1,75,000 Ayushman Arogya Mandirs (AAMs) have been established.
- India’s Universal Health Coverage (UHC) model emphasises public-funded comprehensive primary healthcare, highlighting the need for an integrated approach to health policy and services.
