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World’s Largest Healthcare Program: AB-PMJAY

The Union Minister for Health & Family Welfare, Shri J.P. Nadda at a press conference on Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (PMJAY), in New Delhi on August 27, 2018. The Ministers of State for Health & Family Welfare, Shri Ashwini Kumar Choubey and Smt. Anupriya Patel and the Principal Director General (M&C), Press Information Bureau, Shri Sitanshu R. Kar are also seen.

World’s largest health protection scheme were launched today by PM Modi at Ranchi, Jharkhand. Covering a population the size of the United State, Canada and Mexico, It will have convergence with yoga and Ayurveda too. Notably, It is considered as a wold’s the largest scheme of it’s kind in the globe, PM Narendra Modi mentioned today. Now India takes a giant leap towards providing well accessible and affordable healthcare to the common man with the launch of Ayushman Bharat – Pradhan Mantri Jan AarogyaYojana (AB-PMJAY). Under the transformative goal of AB-PMJAY shall be implemented so that each and every citizen receives his due share of health care.. 

It is a progression towards promotive, preventive, curative, palliative and rehabilitative aspects of Universal Healthcare through access of Health and Wellness Centers (HWCs) at the primary level and provision of financial protection for accessing curative care at the secondary and tertiary levels through engagement with both public and private sectorWith AB-PMJAY, the union government is taking healthcare protection to a new aspirational level. Now it is the “world’s largest government funded healthcare program” targeting more than 50 crore beneficiaries. It can implement the Scheme through an insurance company or directly through the Trust/Society/Implementation Support Agency or a mixed approach.

The Scheme, also called Pradhan Mantri Jan Arogya Abhiyan, aims to provide coverage of Rs. 5 lakh to 10 crore economically backward families. “The PM will launch the scheme on September 23 but effectively it will become operational from September 25 on the birth anniversary of Pandit Deendayal Upadhyay,” argued NITI Aayog member Dr Vinod Paul, who is the chief architect of the scheme.

Ayushman Bharat (AB)  Pradhan Mantri Jan ArogyaYojana (PMJAY) will provide a cover of up to Rs. 5 lakhs per family per year, for secondary and tertiary care hospitalization. Over 10.74 crore vulnerable entitled families (approximately 50 crore beneficiaries) will be eligible for these benefits. It will provide cashless and paperless access to services for the beneficiary at the point of service. The scheme allows states enough flexibility in terms of packages, procedures, scheme design, entitlements as well as other guidelines while ensuring that key benefits of portability and fraud detection are ensured at a national level.

“The number of people covered by the scheme is equal to the population of Europe and the US. The number of people covered in the Ayushman Yojana is equal to the total population of America, Canada and Mexico. This is not a small work,” PM Modi said at 14:05PM today.

The Scheme will help reduce catastrophic expenditure for hospitalizations, which impoverishes people and will help mitigate the financial risk arising out of catastrophic health episodes. Entitled families will be able to use the quality health services they need without facing financial hardships. Notably, When fully implemented, It will become the world’s largest fully government-financed health protection scheme. It is a visionary step towards advancing the agenda of Universal Health Coverage (UHC)

As a substantive purchaser implementing PMJAY, NHA and SHAs will use the tools of pricing and incentives to drive down costs of services in the healthcare sector. The rates that have been fixed for the procedures have undergone a rigorous vetting mechanism in more than 50 cities in the country.

The major goal of the scheme are to reduce out of pocket hospitalisation expenses, fulfil unmet needs and improve access of identified families to quality inpatient care and day care surgeries. The Scheme will provide a coverage up to Rs. 5,00,000 per family per year, for secondary and tertiary care hospitalization through a network of Empanelled Health Care Providers (EHCP). While Pilot launch of the scheme has already started in around 22 states and Union Territories and so far 30 states and union territories have signed a Memorandum of Understanding and started working on implementation of the mission.

The “AB-PMJAY” primarily targets the poor, deprived rural families and identified occupational category of urban workers families as per the latest Socio-Economic Caste Census (SECC) data for both rural and urban areas as well as the active families under the Rashtriya Swasthya BimaYojana (RSBY). All the beneficiaries will be given letters having QR codes which will be scanned and a demographic authentication conducted for identification and to verify his or her eligibility.

© TRILOK SINGH, IASmind.com.

Written by IASmind.com

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