Page 36 - Forbes - India (January 2020)

Pre-Budget sPecial

insurance scheme launched in 2012. “The entire model needs to to official data, almost 20,000 such
“Private players were cooking up be re-thought,” says Soi. “If the centres were fully functioning as of
patients, doing unnecessary surgeries government can reverse auction July 2019. “Much more resources
just to claim the reimbursement,” land in metros for volunteering are needed [`1,200 crore has been
recounts the head of a Gujarat- maximum beds to Ayushman allocated thus far] to fully equip these
based chain of hospitals on the Bharat, large FDI can be attracted centres with the right infrastructure
condition of anonymity. for creating infrastructure. We can and manpower. The insurance scheme
“One day we got an X-ray with then treat Ayushman Bharat patients with its escalating costs diverts funds
the patient’s name scratched out for as well as other [full-fee- paying] away from this,” adds Mukhopadhyay.
checking. Our doctors examined it patients. That is a viable model.”
and said no surgery was required,” he mir hops off the train at
recalls. “We were later told that a knee madhu Kapparath Mumbai's Parel station with a
surgery had already been performed a heavy knapsack slung on one
on that patient… the government shoulder, and weaves his way to the
authorities debarred that hospital.” Tata Memorial Hospital. He has to
Herein lies the flip side of increasing take an appointment for his sister’s
package rates too much and too fast— next visit with the doctor. She was
private players are tempted to profit discharged a week earlier. Dressed in
from the scheme. The AB-PMJAY a white kurta and a skull cap, Amir
authorities, he says, are equally completed his morning classes at the
vigilant. “They have spent lots of time madrassa and got here. “Can’t it be
with our team here to understand done over the phone?” Forbes India
the challenges in implementation.” asks. “It can,” he says haltingly, “but
Meanwhile, artificial intelligence it’s much quicker if you come here
and machine learning are being used and do it. Takes just 10 minutes.”
36 to catch abnormalities in patient “it is, of course, But he quickly adds, “Of course it’s
data and take corrective action if troublesome coming all the way
needed, says AB-PMJAY’s Bhushan. a drain on the from Malad, but it’s for my sister.”
“It is, of course, a drain on the As he waits in queue for his turn,
exchequer to keep increasing the exchequer to keeP he swings his knapsack towards
package rates. That’s understandable,” increasing the his chest and pulls out Tasneem’s
says Abhay Soi, chairman of Radiant Package rates. the file. He points to an ID number on
Life Care, which acquired Max the front. “They need this to give
Healthcare in December 2018. entire Model needs me the appointment,” he explains.
Tiered pricing for different to Be re-thought.” Soon enough Tasneem will have to
hospitals based on geography, hospital start radiation and chemotherapy.
accreditation and patient outcomes abhay SOI, Chairman, Max health Care Ayushman Bharat will cover some
is one solution. “Rates can’t be the and radiant life Care of the cost, but not all of it. Amir
same for an angioplasty done in a opens the file and shows copies of
tier 2 city hospital and one done at the letters he has sent to different
AIIMS or Escorts,” explains Seth. Finally, strengthening primary charitable organisations asking for
Co-payment could be considered care is imperative. The 150,000 monetary help. “Once she’s done
where patients contribute say `10 “health and wellness centres” that with all this, I’d like her to do a
to the scheme every month, says form the first pillar of Ayushman nursing course. And then get some
Shrikhande of Tata Memorial Bharat are an “investment for the practical training at a hospital. I want
Hospital. “This will increase the future”, says Mukhopadhyay of her to be independent,” he says.
pool of money available.” In fact, OP Jindal University. With the Can Ayushman Bharat truly reduce
the next stage of AB-PMJAY, says focus on prevention and early the burden of health care costs on
Apollo Hospitals’ Suneeta Reddy, detection of diseases, especially non- poor families? “I had no hope that
must include India’s middle class. “If communicable diseases (NCDs), these we would come even this far with
the average Indian can spend `500 centres in the long run will protect Tasneem’s treatment. But look
on a digital plan for their phones, an people from falling severely ill and where we are,” says Amir. “We’ll
amount similar to it is well worth reduce the burden on secondary and take one step at a time, Mashallah.
it for good health,” she says. tertiary care hospitals. According Something will work out.”

forbes india • january 31, 2020