Page 31 - Forbes - India (January 2020)

AyushMAN BhArAt

is hollow-eyed and pale, but her “i aM not suggesting that the scheMe needs
high cheek bones and sharp nose
cut a striking figure. Her surgery More Money... i aM saying the insurance
was successfully completed a Model is inherently a cost escalating one.”
few days ago, says her brother,
Amir, who sits by her side. IndranIl MukhOpadhyay, professor, Op Jindal university
“We received help through
Ayushman,” he says measuredly,
referring to Prime Minister Narenda in the first year,” says Dr Indu Public Health Foundation of India.
Modi’s massive government-funded Bhushan, CEO of AB–PMJAY, in an So to provide publicly funded
programme that promises health interview at his New Delhi office. health care to India’s poorest is
insurance to half a billion people. a “game changer”, says Dr Devi
Dubbed ‘Modicare’, the scheme is ndia’s public health record is Shetty, founder and chairman,
built on two pillars: Establishing abysmal. The government spends Narayana Hrudayalaya Hospitals.
150,000 primary health care centres I just about 1 percent of GDP on The premium for providing a `5
to focus on prevention and early health care—one of the lowest levels lakh annual medical cover to each
detection of diseases; and providing a in the world. The US, UK and China family comes to around `1,100 and
cashless cover of `5 lakh per family per spend 8.5 percent, 7.9 percent and 3.2 will cost around `12,000 crore in
year for secondary and tertiary care percent respectively. Neighbouring central and state government funds;
hospitalisation through the Pradhan countries Bhutan and Sri Lanka also costs are to be borne by the Centre
Mantri Jan Arogya Yojana or PMJAY. score better, spending 2.5 percent and states in a 60:40 ratio. When
Around 10 crore families or 50 crore and 1.6 percent, according to the the late Arun Jaitley, as finance
people who make up the bottom World Health Organization. minister, had announced the scheme
40 percent of India’s population as Poor public spending on health in his 2018 Budget speech, he called
per the socioeconomic caste census has meant that access to free, quality it the “world’s largest government-
data (SECC 2011) are eligible. health care at government-run funded health care programme”. 31
Since its launch in September hospitals is sparse. In search of But the challenge lies in
2018, six months ahead of the general better care, poor people wager their its implementation.
elections, 71.69 lakh people have life’s savings, borrow money from AB-PMJAY is an expansion of
benefited from Ayushman Bharat- informal lenders and sell assets to the central government’s Rashtriya
PMJAY, resulting in cost savings pay the bills. Out-of-pocket spending, Swasthya Bima Yojana (RSBY) which
of `10,312 crore for them. Claims which accounts for 65 percent of an has an annual medical coverage
totalling `8,872.5 crore have been individual’s health care expenditure of `30,000, and numerous other
approved as of December 2019. “We in India, pushes 3 to 5 percent of the state government-funded health
have gained tremendous momentum population into poverty, says the insurance schemes that have been

India’s public health spending lags most of its neighbours Out-of-Pocket Expenditure
(OOPE) as a percentage of
Government health expenditure as a percentage of GDP
health expenditure

9.4% BRICS Countries Some Asian neighbours
Maldives
Brazil 44 Bangaldesh 72
3.2%
China
1.6% Russia 40 Bhutan 20
Sri Lanka By 2025 India Malaysia 38
1.1% aims to increase 65
Nepal India
its spending on
health care to Nepal 55
India 1% 2.5% of GDP China 36
Sri Lanka 50
Bangladesh 0.4%
South Africa 8 Thailand 12
Source World Health organisation (WHo), 2015 Source WHo's World Health Statistics, 2018

january 31, 2020 • forbes india