Ayushman Bharat: Transforming Healthcare in India

Do you know what's the best gift you can offer someone? Materialistic items like money, travel, and the coolest merchandise might have popped up in your head right now. Though these things certainly make it to the list, they are not the ones topping the charts. Guess, guess! 🤔

It's for health and fitness. Being in prime health with a disease-free body and stress-free mind are the gifts everyone desires, regardless of age or status.

Interestingly, our government understands this basic need and has thus given citizens from all regions access to a healthy mind and body. They are doing this via the Ayushman Bharat Scheme— the healthcare scheme making India healthier, one step at a time.

On 23 September 2018, the Ayushman Bharat Scheme was launched in Ranchi, Jharkhand, by the Indian Prime Minister Narendra Modi. However, on 14 April 2018, the foundation for the scheme was laid down at Jangla, Bijapur, Chhattisgarh, with the establishment of a Health and Wellness Centre (HWC). This became one of the segments of the Ayushman Bharat Scheme, which we will discuss ahead.

If you're looking for a healthcare scheme that's affordable, accessible, and effective, then Ayushman Bharat is the one for you! In this article, we'll take a closer look at the scheme, its benefits, and how it's transforming the healthcare landscape in India. We'll also explore some of the challenges that are a constant nuisance in making the scheme a perfect success.

So, whether you're a beneficiary of this scheme, a healthcare provider, or simply  curious about this groundbreaking scheme, stay tuned for a fun and informative read! 😌

What is the Ayushman Bharat Scheme?

To achieve the vision of Universal Health Coverage (UHC), Ayushman Bharat was brought forth as a flagship healthcare scheme. With the motive to "leave no one behind", the scheme was designed to meet Sustainable Development Goals (SDGs) as per the recommendations of National Health Policy 2017.

Now, recall how I mentioned that the scheme has different segments? It’s time to take a peek at them and see how they are contributing towards the overall programme:

Health and Wellness Centers (HWCs)

The location beneficiaries visit to access the healthcare professional’s diagnosis under the scheme is known as the Health and Wellness Centres. They provide comprehensive primary healthcare services to the population, including preventive and promotive diagnosis, management of common diseases and conditions, maternal and child healthcare, mental health care, geriatric care and so on.

As of September 2022, around 1,50,000 HWCs were operational across India. Health and Wellness Centers (HWCs) will provide a holistic range of services, including:

• Early identification and basic management of diseases and conditions
• Counselling and support to help patients adhere to their treatment plans
• Follow-up care to ensure that patients are making progress and to identify any potential complications
• Referrals to appropriate specialists for more complex care
• Home and community follow-up to support patients in their recovery and to manage their chronic conditions
• Health promotion and prevention activities to help people stay healthy and avoid diseases in the first place

Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Pradhan Mantri Jan Arogya Yojana provides cashless health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalisation. Ayushman Bharat is also known as the PM-JAY scheme because this represents the "insurance" portion of the initiative.

And so, in the article ahead, we will be using the term “PM-JAY” several times to describe the overall scheme. Hence, dear reader…

Now that you have been introduced to what the scheme entails, let’s see other important factors that make this initiative essential for all.

Particulars of the Ayushman Bharat Scheme

Ayushman Bharat, with its unique set of gifts, has something in store for everyone. Here is everything you need to know about this amazing initiative:

• It is the world's largest government-funded health insurance scheme, covering over 10 crore families and 50 crore beneficiaries.
• The scheme provides a coverage of ₹5 lakh per family per year for secondary and tertiary care hospitalisation.
• It covers up to 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses such as diagnostics and medicines. There is no fixed family size, age, or gender criteria set.
• The PM-JAY scheme is an entirely cashless and paperless initiative, automatically covering parties like bonded labourers and tribe members.

After going through the many particulars of the scheme, I believe you must be convinced of its importance. But that’s not all! We have only covered the first level of the ocean, and there is more to see beyond the surface. So, let’s continue our expedition and see what are the…

Factors That Make Ayushman Bharat Scheme a Catch

As per an economic survey, over 31 crore people are linked under the mission as of January 2023. Among the various government schemes like the Pradhan Mantri Jan Dhan Yojana or Pradhan Mantri Mudra Yojana, PM-JAY is the one that provides such extensive coverage.

Let's cover the factors that makes this scheme an absolute hit among Indian citizens:

Financial Protection:

Sadly, over 1.5 million people in India every year die from the lack of proper healthcare available in the vicinity. Protecting individuals and families from catastrophic health expenditures was one of the major foundations for the launch of Ayushman Bharat. By providing insurance coverage for hospitalisation expenses, it helps reduce the financial burden on households during medical emergencies.

Reducing Out-of-Pocket Expenditure:

Around 45% of the death rate in 2022 was caused by the lack of appropriate care from healthcare institutions, among which people refusing to get treated by the right professionals are also included. Many people in India used to bear the cost of medical treatments from their wallets, leading to a significant financial strain on them.

Ayushman Bharat intends to reduce the out-of-pocket expenditure on health by providing insurance coverage, thereby making healthcare more affordable. With the scope of ₹5 lakh, citizens can get treated without any worries about their health and wealth. In short, both ends are secured.

Strengthening Health Infrastructure:

Ayushman Bharat includes the establishment and strengthening of Health and Wellness Centers at the primary healthcare level. This initiative is crucial for enhancing the overall health infrastructure in the country and promoting preventive healthcare. Now, fewer people need to travel hundreds of miles to receive treatments.

Benefiting the Underprivileged:

We have all seen on news channels and read newspaper columns about villages with no single hospital. The scheme focuses on covering economically vulnerable sections of society, including rural and urban poor, to ensure that they have access to quality healthcare services. This is aligned with the goal of reducing health inequalities. India's motto of "Unity in Diversity" is well expressed via these schemes.

Job Creation:

With a rate of 7.45% in February 2023, unemployment has been one of the biggest problems in India. The launching of such schemes creates openings for more doctors, nurses, and other professionals, developing job opportunities for millions.

The implementation of Ayushman Bharat involves the participation of both public and private healthcare providers. This can contribute to job creation and economic growth in the healthcare sector.

Focus on Primary Healthcare:

The Health and Wellness Centers under Ayushman Bharat aim to provide comprehensive primary healthcare services, including preventive and promotive healthcare. By strengthening primary health care, the scheme addresses health issues at an early stage, preventing disease progression and reducing the burden on secondary and tertiary care facilities.

Digital Health Initiatives:

Ayushman Bharat incorporates digital technologies for efficient implementation and monitoring. This includes the use of technology for beneficiary identification, claim processing, and overall program management, contributing to the advancement of digital health initiatives in the country.

Global Recognition:

Ayushman Bharat has garnered attention globally as one of the largest government-sponsored healthcare insurance programs. Its scale and ambition make it a noteworthy initiative in the global healthcare landscape. Our government sure knows how to make Indians all over the world proud. 🤗

Challenges to Overcome

Every programme has its share of issues and shortcomings. The same applies to this government scheme. Let’s take a look at the major challenges blocking the PM-JAY scheme from being the ultimate healthcare option:

Oblivious Beneficiaries:

Despite being a Pradhan Mantri Yojana, not many are aware of this scheme. In rural areas with low internet networks and even lower healthcare options, many people are travelling miles to get treatments for fundamental issues. On the other hand, many beneficiaries are unaware of their eligibility or how to access the scheme.

Corruption & Fraud

As you can see in the infographic below, the government of India allocates a big sum for the Ayushman Bharat Scheme.

There have been reports of multiple fraud and corruption in the scheme. The budget distributed to various components ends up being a medium of misconduct by dishonest officers and related parties. Hence, the beneficiaries are unable to take advantage of the scheme devised for them. 

The Bottom Line

Next time you're feeling overwhelmed by the high cost of healthcare, just remember that Ayushman Bharat is here to save the day. It's the superhero who's making healthcare more affordable and accessible for all Indians.

It's essential to note that the impact and significance of Ayushman Bharat can evolve over time based on the ongoing implementation, challenges faced, and improvements made to the program. For the most current information and developments, it's recommended to refer to the latest sources as of your current date in 2023.