The Government of India is cognizant that primary Health Care is currently focusing largely on Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) and communicable diseases. This poses a challenge given the epidemiological transition, where non-communicable diseases accounts for nearly 62% of deaths among men and 52% among women – most of which are premature in nature. The situation is exacerbated by the fact that there is low utilization of public health system, especially at the level of Community Health Centre (except for child birth related services). There is lack of effective gate-keeping and referral, leading to fragmentation of health care services. Families are forced to incur high out of pocket expenditure thereby leading to impoverishment and poverty on account of medical and hospitalization expenses.
Health is an important cornerstone to the Government’s vision of development, ‘Swasth Bharat, Samriddha Bharat (Healthy India, Prosperous India). To fulfil the vision of Health for All and Universal Health Coverage, enshrined in the National Health Policy 2017, the Government conceived Áyushman Bharat’ (Healthy India), a pioneering initiative led by Hon’ble Prime Minister. Ayushman Bharat (AB) is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Ayushman Bharat aims to undertake path breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level. Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components.
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The first component, pertains to creation of 1,50,000 Health and Wellness Centreswhich will bring health care closer to the homes of the people. These centres will provide Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services. The first Health and Wellness Centre was launched by the Hon’ble Prime Minister at Jangla, Bijapur, Chhatisgarh on 14 April 2018. The second component is the Pradhan Mantri Jan Arogya Yojana (PM-JAY) which provides health protection cover to poor and vulnerable families. The Health and Wellness Centres will play a critical role in creating awareness about PM-JAY, screening for non-communicable diseases, follow-up of hospitalisation cases among others. These two far-reaching initiatives under Ayushman Bharat will build a New India 2022. This path-breaking initiative, which will be implemented at an unprecedented scale will bring a paradigm shift in India’s health sector. It will help India capitalize its demographic dividend, ensure enhanced productivity, well-being and avert wage loss and impoverishment.
Benefits of PM-JAY
- Government provides health insurance cover of up to Rs. 5,00,000 per family per year.
- More than 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries) covered across the country.
- All families listed in the SECC database as per defined criteria will be covered. No cap on family size and age of members.
- Priority to girl child, women and and senior citizens.
- Free treatment available at all public and empaneled private hospitals in times of need.
- Covers secondary and tertiary care hospitalization.
- 1,350 medical packages covering surgery, medical and day care treatments, cost of medicines and diagnostics.
- All pre-existing diseases covered. Hospitals cannot deny treatment.
- Cashless and paperless access to quality health care services.
- Hospitals will not be allowed to charge any additional money from beneficiaries for the treatment.
- Eligible beneificiares can avail services across India, offering benefit of national portability. Can reach out for information, assistance, complaints and grievances to a 24X7 helpline number - 14555
- Help India progressively achieve Universal Health Coverage (UHC) and Sustainable Development Goals (SDG).
- Ensure improved access and affordability, of quality secondary and tertiary care services through a combination of public hospitals and well measured strategic purchasing of services in health care deficit areas, from private care providers, especially the not-for profit providers.
- Significantly reduce out of pocket expenditure for hospitalization. Mitigate financial risk arising out of catastrophic health episodes and consequent impoverishment for poor and vulnerable families.
- Acting as a steward, align the growth of private sector with public health goals.
- Enhanced used to of evidence based health care and cost control for improved health outcomes.
- Strengthen public health care systems through infusion of insurance revenues.
- Enable creation of new health infrastructure in rural, remote and under-served areas.
- Increase health expenditure by Government as a percentage of GDP.
- Enhanced patient satisfaction.
- Improved health outcomes.
- Improvement in population-level productivity and efficiency
- Improved quality of life for the population