Time to review public health insurance

HEALTHY families are the foundation of healthy communities, thus, there is nothing more important than good health and reliable healthcare for the family.

- MOIN QAZI

Universal health coverage aims to ensure that all people receive quality healthcare without suffering financial hardship. The biggest challenge is to combat the multiple scourges ravaging the world’s poor and sick. Due to the current pandemic we are facing pressing challenges and health-related expenditure has now become a primary route to impoverishment. India took a great leap in public health insurance when it launched the Prime Minister Jan Arogya Yojana (PM-JAY) and the Ayushman Bharat (AB) scheme. These are the country's flagship structures created to help universalise healthcare so that economically vulnerable families get the medical care they need without being pushed into debt. The cost to the Government is around Rs 1, 052 per family, with 60 per cent of it being borne by the Centre and the rest by States. Although the scheme has several laudable objectives and novel features, it has its limitations. Despite having an apparently formidable beneficiary base, the AB-PMJAY still has a small share in the overall inpatient care provision. This is due to low empanelment of hospitals, a general reluctance of private providers towards dispensing AB-PMJAY benefits, and limited contribution of AB-PMJAY to the overall business of hospitals. The Government pays public and private hospitals fixed rates for treating people covered under the programme and this doesn't fit in with the viability of the private sector. New ways will need to be explored to see how the private sector can be co-opted in the delivery of public health. At the same time, the public health system particularly in rural India will have to be regenerated.