‘Healthcare costs should not financially destroy families’

The CEO of the Pradhan Mantri Jan Arogya Yojana on the challenges and scope of the health insurance scheme and responses from the States Indu Bhushan is the CEO of the world’s largest government-funded health insurance scheme, the Pradhan Mantri Jan Arogya Yojana (PM-JAY), which was launched by Prime Minister Narendra Modi on September 23. Until his appointment as CEO of PM-JAY, Mr. Bhushan served as director general for the East Asia Department of the Asian Development Bank, before which he worked as a senior economist with the World Bank Group. Here, he explains how the scheme works and the challenges it faces. Excerpts: After many months of preparation, talks and planning, India has finally launched its ambitious Ayushman Bharat insurance scheme to benefit the poorest of the poor. Where do we stand today in terms of coverage offered and hospitals empanelled? It’s true that before the scheme was rolled out, several ground-level surveys were carried out, research and planning was initiated, and a robust IT department was set up. The sheer scale at which Ayushman Bharat was to be rolled out made it necessary that we create a strong foundation on which we can operate, build and grow. The idea was to reach out to the poorest families who have no health cover. The bottom 40% is the group that we want to cover. Since the scheme was announced, we have 79,000-plus beneficiary admissions and empanelled hospitals from across the country. We have issued more than a lakh PM-JAY e-cards to beneficiaries. The scheme is for poor families and has identified the occupational category of urban workers’ families: 8.03 crore in rural areas and 2.33 crore in urban areas, according to the latest Socio-Economic and Caste Census data. How has the backbone of the scheme, the IT department, performed till now? There was news about some hold-ups. When will the system see a smooth run? When you bring in a scheme of this nature and at the scale that we have launched, there are bound to be some problems. There are thousands of hospitals still coming on board and there will be always be some problem in the sense that they have given some wrong names and IDs to some hospitals and we need to fix that. Hospitals are providing a number of packages but we have mapped different packages for these hospitals. And so on. Minor glitches will keep surfacing. So, there is nothing wrong with the IT system, but adapting that for each hospital, each State isn’t simple. In India, each State has a different system — like a mixed model (private/government), trust, insurance… each of them has a different flow. Manpower has to be trained and managed accordingly. Mapping these diversities, updating the technology as the flow eases out, adding features which we feel are useful, etc. is what we are doing now. And that will continue. I don’t think we will reach total perfection in that sense. But by and large I am giving it four weeks to iron out the big clogs, and I think we should be in good shape by the end of October. Here I would like to state that not just software but also the training of people is a very vital portion of the scheme. For example, I was at Safdarjung Hospital [in Delhi] where they told me that finding people’s names using our software was taking 20 minutes. I told them that it can’t be. I showed them and it took less than a minute. So, getting used to the system is equally important.

Source : https://www.thehindu.com/todays-paper/tp-opinion/healthcare-costs-should-not-financially-destroy-families/article25304551.ece

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