Ayushman Bharat or National Health Protection Scheme: Dubbed by ministers and BJP leaders as ‘Modicare’, the full roll-out of the NHPS will be on September 25.
Officials said that with the scheme set to incur a huge financial burden on the state, the government would now assess whether it can implement a hybrid insurance model or needs to opt for a trust model for the beneficiaries.
During a visit to Delhi some time ago, Chief Minister Mamata Banerjee had cited Swasthya Saathi, and said her state already has a scheme and it made little sense to join the NHPM.
While the unscheduled Rs 22,000 crore farm loan waiver has left Maharashtra with no funds to join the NHPM, Rajasthan has cited logistical concerns in implementing the scheme.
The official said that though the Rajasthan government has welcomed the Centre’s scheme, “they are not sure how to implement it, as they already have Bhamashah Swasthya Bima Yojana, under which cashless health care services are provided to around 4.5 crore people”.
August 15 was one of the putative dates for the launch, but there were doubts about whether preparations would be complete by then, which is why a second date of October 2 was also on the horizon.
The first meeting of Ayushman Bharat-National Health Protection Mission Council (AB-NHPMC) that will give policy directions and foster coordination between Centre and States will happen in Delhi on June 14.
Claim ratio is calculated as the total value of all claims paid by the company divided by the total amount of premium collected in a financial year. A claim ratio of 75-90 is usually thought to be an indicator of a robust claim settlement system by an insurer.
The NHPM is designed to prevent catastrophic health expenditures. According to government data, in-patient hospitalisation expenditure in India increased nearly 300 per cent in the last ten years.
The Ayushman Bharat scheme promises to provide health cover of Rs 5 lakh per family per year. The scheme will subsume the on-going centrally sponsored schemes – Rashtriya Swasthya BimaYojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
India’s healthcare needs monitoring systems, not public vs private sector debate.
In the absence of the 10 public health professionals who are usually the ones asking all the questions in the MSG meetings, it was left to Niti vice-chairman Rajiv Kumar to seek explanations.
Many state governments have been successfully running health insurance programmes. Centre needs to study them before rolling out the National Health Protection Scheme.
In the Union Budget 2018-19, an initial corpus of Rs 2,000 crore was provided for the NHPS that aims to provide medical cover of Rs 5 lakh to over 10 crore poor and vulnerable families.
A National Health Agency (NHA) is also to be set up to manage NHPS, the letter from Union Health Secretary Preeti Sudan to all state Chief Secretaries stated.