All life-saving procedures including chemotherapy and radiation therapy, that are ordinarily used for treatment of cancer, will be covered under the National Health Protection Mission (NHPM). However, organ transplants will not be covered.
The Union cabinet on Wednesday approved the mission that will provide a Rs 5 lakh health cover to 10.74 crore families based on deprivations as listed in SECC data. Health Minister J P Nadda repeatedly asserted on Thursday that misgivings about the financial implications notwithstanding, “there will be no shortage of money.” Replying to a question about the procedures that will be covered under NHPM, health secretary Preeti Sudan said: “All life-saving procedures will be covered, including chemotherapy and radiation therapy. But for now, in the first phase, organ transplants will not be covered.”
NHPM will be a cashless, paperless transaction for all beneficiaries. Organ transplants are among the most expensive procedures, with liver transplants costing a minimum of Rs 20 lakh. A kidney transplant is less expensive — Rs 4-5 lakh. Because of the burgeoning burden of diabetes and hypertension, India has rising numbers of people suffering from chronic kidney disease.
According to estimates of the health ministry, every year about 2.2 lakh new patients of End Stage Renal Disease (ESRD) get added in India. That is why the Centre had launched a National Dialysis Programme two years ago. The logical next step for many people on dialysis is a kidney transplant.
The categories of people eligible for NHPM in rural areas include families having only one room with kucha walls and kucha roof, families having no adult member between age 16 and 59, SC/ST households, and landless households deriving major part of their income from manual casual labour. For urban areas, 11 defined occupational categories are entitled to the scheme.
In his statement on the mission that is set to be the health flagship of the NDA government, as NRHM was for UPA, Nadda said this would be the first step towards universal health coverage. Ayushman Bharat-NHPM, he said, will leverage Comprehensive Primary Health Care through Health and Wellness Centres for preventive, promotive and curative care and ensure seamless continuum of care.
“This will avoid overcrowding and improve quality of care at secondary and tertiary facilities and provide universal health coverage and make services equitable, affordable and accessible. All public hospitals in states implementing Ayushman Bharat-NHPM will be deemed empanelled for the scheme. As for private hospitals, they will be empanelled online based on defined criteria,” Nadda said.
In the absence of any public scheme to protect the health of individuals, catastrophic health expenditure is among the leading causes of impoverishment in India, made worse by the poor condition of government hospitals and exorbitantly priced private hospitals. According to government data, in-patient hospitalisation expenditure in India has increased nearly 300% in the last 10 years. (NSSO 2015). More than 80% of the expenditure is out of pocket (OOP). Out of pocket expenditure in India is over 60%, which leads to nearly 6 million families getting into poverty due to catastrophic health expenditure.