Ayushman Bharat programme has been rolled out recently, it is compared with USA’s Obama Care.
To make the program successful various issues in the Indian Insurance systems needs to addressed.
What is Ayushman Bharat?
The programme is aimed at making interventions to address health holistically, in primary, secondary and tertiary care systems.
The initiatives under the programme are:
Health and Wellness Centre - The centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services.
National Health Protection Scheme - The scheme provides coverage of upto Rs. 5 lakh per family per year for secondary and tertiary care hospitalization.
Besides, 24 new Government Medical Colleges and Hospitals will be set up, by up-grading existing district hospitals in the country.
This would ensure that there is at least 1 Medical College for every 3 Parliamentary Constituencies and at least 1 Government Medical College in each State of the country. Click here to know more.
How Ayushman Bharat differs from Obama care in USA?
Size of the project - The Obama Care in USA as a coverage of roughly two crore adults aged 18–64.
India’s Ayushman Bharat proposes to cover 10 crore families, the grandness in India’s scheme is due to its scale as it aims to cover nearly 25 times as many beneficiaries.
Budget of the mission - For Obama care the U.S. budgetary provision through an excise tax was $16.3 billion in the fiscal year 2015, which is Rs. 97,800 crore.
Accounting for the difference in medical costs between the two countries for India it costs 200 times more than Obama Care.
What are the issues in Ayushman Bharat?
Rashtriya Swastha Bima Yojana (RSBY), an existing domestic medical insurance scheme, the actual expenditure for Financial Year 2017-18 was only Rs. 470.52 crores, as opposed to the budgeted Rs. 1,000 crore.
It covered around 3.63 crore families up to a maximum expenditure of Rs. 30,000 in health-care costs.
The corresponding targets for Ayushman Bharat are 10 crore families and a maximum coverage of Rs. 5 lakh.
Since the coverage rises by about three times (10 crore/3.63 crore), Ayushman Bharat would require an allocation of more than Rs. 26,000 crore, 13 times as high as the current allocation.
Apart from this the Ayushman Bharat scheme fails to deliver on the promise it makes to the more than 50 crore Indians not having any health coverage.
With mounting medical costs and an insurance coverage that is ephemeral, these citizens will be left high and dry.
What are the issues with Indian insurance systems?
A central argument in favour of insurance-based system is that it is more efficient in terms of delivery and coverage with less financial burden on the government.
But the experience of RSBY shows evidence that there has been an increase in hospitalisation in private hospitals and, as a result, the expenditure not covered under the scheme has risen.
Moreover, most insurance schemes do not cover out-patient visit costs, which are significantly higher for chronic illnesses.
If there is public provisioning of such services, the burden of spending would not have fallen on the patients.
Further, insurance-based government schemes have an inbuilt inflationary bias.
