Ayushman Bharat Initiative Marks 8 Years Since Its Rollout. | Current Affairs | Vision IAS

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In Summary

  • Ayushman Bharat, launched in 2018, is the world's largest healthcare scheme with over 60 crore beneficiaries, aiming for Universal Health Coverage.
  • It comprises Ayushman Arogya Mandir for primary care and PM-JAY, providing ₹5 lakh cover per family for secondary/tertiary care hospitalization.
  • Challenges include exclusion errors, private hospital reluctance due to low reimbursement, administrative shortfalls, and poor infrastructure in empanelled hospitals.

In Summary

With more than 60 crore beneficiaries, it is the largest healthcare scheme in the world.

Key features 

  • Launched: 2018
  • Aim: achieving Universal Health Coverage (UHC)
  • Type: Centrally Sponsored Scheme
  • Implementation: National Health Authority (NHA) at central level and state health agencies at state level 
  • Components: Ayushman Arogya Mandir (AAM); Pradhan Mantri Jan Arogya Yojana (PM-JAY)
  • AAM(Health and Wellness Centres): to deliver free and universal Comprehensive Primary Health Care
  • PM-JAY: Largest health assurance scheme which provides a cover of ₹5 lakh per family per year for secondary and tertiary care hospitalization
    • Coverage: Covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization care across any empanelled public or private hospital 
    • Beneficiaries: Originally bottom 40% based on Socio-Economic Caste Census 2011. 
      • However it has been expanded to cover all senior citizens aged 70 and above and 37 lakh families of ASHA and Anganwadi workers
    • Others: no restrictions on family size, age, or gender, cashless treatment, 

Achievements

  • Massive Beneficiary Reach: Ayushman Bharat has expanded to cover over 60 crore beneficiaries, with more than 48.54 crore Ayushman cards
  • Strengthened Primary Health care: Ayushman Arogya Mandirs have recorded over 500 crore visits in line with Declaration of Alma-Ata
  • Reducing Out-of-Pocket Health Expenditure: It has been reduced to 43.4% (2022)

Challenges associated 

  • Exclusion Errors: For example, a CAG audit in Bihar revealed that only 41% of targeted households were verified
  • Private Hospital Reluctance: Low reimbursement rates and delayed payments have discouraged major private hospitals from participation
  • Administrative Shortfalls: significant unspent balances, delayed release of matching state funds, and high staffing vacancies
  • Poor infrastructure: Some of the Empanelled hospitals did not fulfil minimum criteria of support system and infrastructure
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CAG audit

An audit conducted by the Comptroller and Auditor General of India, an independent constitutional authority responsible for auditing all receipts and expenditures of the Union and State governments. CAG audits are crucial for assessing the efficiency and accountability of government programs.

Out-of-pocket health expenditure

Out-of-pocket health expenditure is the amount of money individuals spend directly from their own funds for healthcare services and goods, without any insurance or government support. The article shows a significant reduction in this, indicating improved affordability and reduced financial burden on households.

Socio-Economic Caste Census 2011

A comprehensive survey conducted by the Government of India to identify households that are eligible for various government assistance programs based on their socio-economic status. It formed the basis for beneficiary identification in many social welfare schemes, including PM-JAY.

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