A Contentious Solicitation

India's most ambitious health insurance scheme, Pradhan Mantri Jan Arogya Yojana, is definitely a lure. Millions of Indians bleed to pay their ever-increasing medical expenses in private healthcare and end up becoming even poorer. Experiences of public-funded health insurance schemes in the last decade show that these initiatives have not been effective as they are not supported by the proportionate creation of public health systems. India simply doesn't have enough well-equipped public health infrastructure. So what does this new scheme mean for millions of poor and sick people? KUNDAN PANDEY travels to Rajasthan, Tamil Nadu, Haryana, Telangana and Kerala to understand what the new scheme needs to be cautious about.

- Kundan Pandey

ON AUGUST 15, Karishma acquired a new identity. By lottery, she was chosen as the first beneficiary of the world’s largest government health insurance scheme—Pradhan Mantri Jan Arogya Yojana (PMJAY). “First claim raised under #AyushmanBharat. A baby girl is born through caesarean section at Kalpana Chawla Hospital in Haryana. Claim of R9000 paid to the hospital by Ayushman Bharat-Haryana…,” tweeted Dinesh Arora, deputy chief executive officer, Ayushman Bharat, under which PMJAY will be implemented. Her family is already basking in the glory of this superlative. Every breath of Karishma will be now tracked, literally.

Her family’s new-found happiness represents what a health insurance scheme means to an economically challenged household. For such families, 70 per cent of spells of ailment are treated in the private sector, which is three times more expensive than treatment in public sector hospitals. It must be remembered that 86 per cent of India’s rural population is not covered under any health expenditure support, according to the National Sample Survey Office’s (NSSO’S) 71st round of survey on health. The ₹9,000 reimbursement to the hospital, where Karishma was born, is a huge sum given that India’s per capita annual expenditure on healthcare is ₹13,000.