The Pradhan Mantri Jan Arogya Yojana (PMJAY), launched as protection against large expenses arising out of serious illnesses, has seen the most claims for relatively minor procedures like cataract surgery and root canal treatment, available data from several states for the first two months of the scheme show.
The data, from greenfield states, also show a high incidence of claims for enteric fever or typhoid. The data are yet to be fully integrated, and the final picture could, therefore, be somewhat different.
Greenfield states are those that had no health insurance scheme before PMJAY. They include some of India’s poorest and most populous states, including Uttar Pradesh, Bihar and Madhya Pradesh, apart from Chhattisgarh, Himachal Pradesh, Haryana, Jharkhand, Uttarakhand, Jammu & Kashmir, and all of the Northeast.
Between September 23, when the scheme was officially launched, and November 24, 6,900 claims were made for cataract surgery, and 4,900 for root canal treatment, official data show. A total 3,400 claims were made for the typhoid package during this period.
PMJAY is the tertiary care arm of the government’s flagship Ayushman Bharat scheme, under which 10.74 crore families will be provided an annual health cover of Rs 5 lakh. The other part of the scheme is the setting up of 1,53,000 health and wellness centres, the first of which was inaugurated in April in Bijapur in Chhattisgarh.
All states except Telangana, Odisha and Delhi have signed the Memorandum of Understanding with the newly created National Health Agency (NHA), the implementing authority for the PMJAY. Rajasthan has signed the MoU, but is yet to implement the scheme.
The PMJAY, billed as the most ambitious health scheme in the world, is one of Prime Minister Narendra Modi’s flagship social welfare initiatives. The NHA has been filing a report of its progress to the Prime Minister’s Office at 5 pm every day since the launch of the scheme, including on weekends, holidays, and festival days. The daily report includes updates on the numbers of health cards issued, beneficiaries admitted, and claims raised, and even the numbers of calls answered and letters despatched to beneficiaries. The health scheme has made an occasional appearance in Modi’s campaign speeches in the ongoing Assembly elections.
The process of automatic integration of data from the states is not complete yet. Once that is done, the PMJAY dashboard will be made public.