Today onwards, nobody will be
poor in India, from the health point of view. Now, all needy people will have
an insurance of Rs 5 lakh with the premium paid by the government.
The Prime Minister, Shri
Narendra Modi, will launch the Ayushman Bharat scheme, officially known as the
Pradhan Mantri Jan Arogya Yojana (PM-JAY) today in Ranchi, Jharkhand.
The scheme will provide
insurance cover of up to Rs 5 lakh per family per year at any government or
empanelled private hospital all over India, for secondary and tertiary care
hospitalization. More than 10 crore poor and economically deprived families and
more than 50 crore people will benefit. There is no restriction on family size,
age or gender. All pre-existing conditions are covered from day one of
the policy. The benefit cover includes both pre and post hospitalization
expenses.
All workers in India, who earn
less than 21,000 INR per month are already covered under the Employees’ State
Insurance (ESI) Scheme.
Getting the insurance premium
paid by the government will now be a fundamental right for those who are
eligible for the scheme.
All hospitals and health care
establishments, who have committed 10% free work for the economically weaker
section (EWS) of the society will now get paid under the scheme; also, all
government hospitals will start getting some reimbursements under the scheme.
So, more and more people will now opt for private wards in government
hospitals.
Health is already a
fundamental right under Article 21 of the constitution of India and improvement
of the public health is a primary duty of the government under Article 47,
under the Directive Principles of State Policy, based on the means available, which mandates the government “to raise the level of
nutrition and the standard of living and to improve public health”. And, if
the required means are not available, the state government can then mandate all
private hospitals to enroll under this scheme.
Because all emergent health
conditions will be paid for under the insurance scheme for the poor and the
needy, hospitals will no more have an excuse to refuse treatment and 100%
hospitals will have to comply.
Time has come for universal
health coverage and to make quality health care “available”, “accessible”,
“affordable” to all and also “accountable”. The Ayushman Bharat scheme is one
step towards this end.
For those who can pay, it must
be mandatory to get an insurance for at least Rs 5 lakh, which will become a
minimum benchmark for health insurance in India.
Once 100% people are insured,
health care will become affordable over time to everyone. Treatment costs will
automatically reduce.
The two types of insurance
(Ayushman and non Ayushman), two types of premiums, two types of packages and
two types of treatment will also invariable undergo auto correction.
Dr KK Aggarwal
Padma
Shri Awardee
President
Elect Confederation of Medical Associations in Asia and
Oceania
(CMAAO)
Group
Editor-in-Chief IJCP Publications
President
Heart Care Foundation of India
Immediate Past National President IMA
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