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.
