The Ayushman Bharat-National Health Protection Mission (NHPM) is likely to be a part of Prime Minister Narendra Modi’s Independence Day speech. Ayushman Bharat CEO Indu Bhusan told The Indian Express on Thursday that after the first health ministers’ conclave on the mission in Vigyan Bhawan, there was a sense of urgency as “we have exactly two months left for the launch”.
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. Bhusan’s “two-month” urgency is the first official indication that the government has now zeroed in on the first date.
At the conclave in Vigyan Bhawan, touted as a “soft launch” of the mission, 20 states and UTs agreed to come on board. These include Assam, Bihar, Chhattisgarh, Gujarat, Haryana, Himachal Pradesh, Jammu and Kashmir, Jharkhand, Madhya Pradesh, Uttar Pradesh and Uttarakhand. Four northeastern states, Manipur, Meghalaya, Mizoram and Nagaland, too have signed MoUs.
“I found the meeting extremely positive. My one takeaway from it was that though a lot of work has been done, a lot more needs to be done. States need to get going. Though 19 states have got cabinet approval, 17 states still need to get it. After that RFPs will be issued, partners identified. From today it is just two months to August 15, we have no time to waste before the launch. By the end of this month, we hope to have 28 states on board,” Bhusan told The Indian Express.
Though neither West Bengal nor Punjab participated in the conclave, Bhusan was hopeful that both would eventually come on board.
The conclave on NHPM on Thursday saw a large number of states talking about their bitter experiences with insurance companies to bat for implementation of the mission through trusts rather than private players. Health Minister J P Nadda told the meeting that the ideal situation would be to implement the mission completely through trust mode. But not all states are at the same level of preparedness, hence the need for flexibility.
Haryana Health Minister Anil Vij was very critical of insurance companies. Most problems faced by the state in its own health programme, he said, were because of insurance companies and in the empanelment of private hospitals. Gujarat Deputy CM Nitin Patel spoke about the state’s experience with the crop insurance scheme and health insurance scheme to make a case for implementation in trust mode. The poor, he said, cannot be made to run from pillar to post for their needs, he added.
Bhusan said that states did share “information about how insurance companies did not always keep their end of the bargain. Gujarat talked about the Fasal Bima Yojana and others shared their experiences.”
NHPM director Dr Dinesh Arora said: “Our key takeaway from today is that mixed mode implementation, like it is being done by Gujarat, is a very good option. There insurance provides for bills of up to Rs 50,000 while for higher amounts it automatically goes to the trust. Nine states are going for mixed mode implementation, but we feel the Gujarat model is worth exploring.”
Maharashtra Health Minister Deepak Sawant was not convinced about the trust mode as, he said, the state’s experience was that getting work done was difficult in the trust mode. He also said that the state’s experience with the Mahatma Jyotiba Phule Jan Arogya Yojana has been that procedures such as deliveries — both ceasarean section and normal — and cataract surgeries should not be allowed in private facilities.