Ayushman Bharat Diwas: Understanding the Significance of the Day

It was on September 23, 2018, that Prime Minister Narendra Modi launched in Ranchi, the Pradhan Mantri Jan Arogya Abhiyan, or the Ayushman Bharat Yojana. Also known as the National Health Protection Mission (AB-NHPM), or Modicare, this scheme is known to provide the largest health cover in the world at five lakh rupees per family per year. 

Significance of Ayushman Bharat Yojana

Ayushman Bharat Yojana is celebrated as Ayushman Bharat Diwas on April 30 in India. It has a twin mission – to promote health and wellness to the economically poor and backward sections of the country and to provide insurance benefits to them. Other objectives of the scheme are to reduce out-of-pocket hospitalization expenses, fulfill needs, and improve access of identified families to quality inpatient care and daycare surgeries. 

Aim of Ayushman Bharat Yojana

The aim is to provide affordable medical facilities to the remote areas of the country based on the Socio-Economic Caste Census (SECC) database. As part of the National Health Policy of 2017, “Healthy India” initiative was launched to accomplish the vision of Universal Health Coverage (UHC). The said scheme is implemented in 3 modes:

1. Insurance mode, 
2. Mixed mode, and 
3. Trust mode 

The bottom 40% of the Indian Population is to benefit from this Yojana. The categories that will be automatically included consist of: 

1. Households without shelter 
2. Destitute/ living on alms 
3. Manual scavenger families 
4. Primitive tribal groups 
5. Legally released bonded labor 

The eligibility criterion for the rural areas is:

1. SC/ST households 
2. Families living in one room with ‘kuccha walls and kuccha roof’ 
3. Families having no adult members between the age of 16 and 59 
4. Families headed by a female with no male adult member aged between 16 and 59   
5. Families with at least one disabled member and no member with an abled body  
6. Landless households receiving income from manual casual labour 

And for urban areas is:

1. Beggar 
2. Rag picker 
3. Domestic worker 
4. Washerman/ chowkidar 
5. Sweeper/ sanitation worker / gardener 
6. Electrician/ mechanic/ assembler/ repair worker 
7. Home-based worker/ artisan/ handicrafts worker / tailor 
8. Painter/ construction worker / welder/ plumber/ mason/ labour/ security guard/ coolie and other head-load workers 
9. Street vendor/ hawker/ cobbler and other service providers working on the streets 
10. People helping drivers and conductors/ conductors/ Transport workers/ drivers/ cart puller/ rickshaw puller 
11. Shop worker/ peon in small establishment/ helper/ assistant/ waiter/ attendant/ delivery assistant 

The number of eligible beneficiaries under SECC 2011 started at 10.74 Crore families (50 Crore people). The States/UTs implementing AB PM-JAY have further expanded the coverage of the scheme and now the number of eligible beneficiaries stands at 13.13 Crore families (65 Crore people).   

Benefits of Ayushman Bharat Yojana

The benefits under AB PM-JAY can be accessed by the eligible beneficiaries on a pan-India basis, offering the benefit of national portability. Beneficiaries can reach out for information, assistance, complaints, and grievances to a 24X7 helpline number – 14555. It is an entitlement-based scheme, and does not require enrolment; however, the beneficiary verification process is being undertaken to verify the genuineness of the beneficiary. An eligible person can visit any impaneled public or private healthcare facility in India for cashless hospitalization. 

1. All eligible beneficiaries are issued E-cards as part of this process. E-card generation drives have commenced in States/UTs under mission mode. All the verified families will be covered as soon as the scheme is implemented in the State/UT.  
2. Priority, under this scheme, is given to a girl child, women, and senior citizens. Orphan children will also get the benefit of Ayushman Bharat.  
3. It covers all pre-existing diseases and services for around 1300+ procedures. Hospitals cannot deny treatment for the same. This scheme is a significant step toward the achievement of Universal Health Coverage (UHC) and Sustainable Development Goal – 3 (SDG3).
4. The scheme covers 3 pre-hospitalization days and a maximum of 15 post-hospitalization days for the expenses related to medicines and tests. This has proved to be one of the most significant factors leading the scheme to achieve major healthcare goals, as per the United Nations’ standards. 
5. The Narendra Modi government’s flagship initiative was introduced along the lines of universal health care to satisfy one of the United Nations’ Sustainable Development Goals (SDGs) – “leave no one behind.”

According to the then Health Minister, Dr. Harsh Vardhan, India has operationalized 75,532 Ayushman Bharat-Health and Wellness Centres (HCW) so far despite the COVID-19 pandemic and is on track to functionalize 1.5 lakh HWCs by December 2022. 

Conclusion

Running such a huge healthcare plan in a vast country like ours is also fraught with problems, and critics say the scheme is not economically viable. The scheme majorly lacks funding. In India, healthcare is highly fragmented. The cost and quality of this plan vary a lot. So, even while the thought process behind this initiative was great, it remains to be seen whether the scheme has borne the desired results.