Page 19 - Insurance Times August 2019

villages. The government also has a provision of extending
free treatment to the poor by reserving some beds in private
hospitals. However, most private hospitals claim they don't
get enough poor and underprivileged patients for free beds.

The health ministry is currently detecting, correcting and
deleting inaccurate records from its database for targeted
beneficiaries. While contacting rural beneficiaries to inform
them about their entitlement for NHPS has been
strategically planned, the major task for the government
now is finding the actual whereabouts of urban
beneficiaries. The NHPM is an entitlement-based scheme
and the biggest challenge is to reach out to poor and tell
them that they are entitled for this scheme.

Census (SECC). Beneficiaries under NHPM can avail of Delivery mechanism of the scheme:
benefits in both public and empanelled private facilities. Ayushman Bharat - National Health Protection Mission will
Health policy experts claim that the scheme will prove to target about 10.74 crore poor, deprived rural families and
be a game changer with poor families benefiting the most. identified occupational category of urban workers' families
The NHPM has included people on the criteria of profession. as per the latest Socio-Economic Caste Census (SECC) data
covering both rural and urban. The scheme is designed to
The urban space is geographically diffused and the poor be dynamic and aspirational and it would take into account
population in urban areas is fluid. The population keeps on any future changes in the exclusion/ inclusion/ deprivation/
coming in, going out and migrating within as well as outside occupational criteria in the SECC data. 1950, the year India
the urban space. There may come some inherent difficulties became a republic, was also the year when several nations
in communicating with this chunk of urban population. As acknowledged the need to join forces on issues of health.
this is a national scheme and has to be implemented in Since then, 7 April has been celebrated as World Health Day,
partnership with the states, they will have to find out ways also the anniversary of the World Health Organization
to reach out to the lowest quintile of their areas. (WHO). WHO's theme for this year's World Health Day is
universal healthcare, an exact match with Indian
The expenditure incurred in premium payment will be government's vision of Ayushman Bharat, powered by the
shared between Central and State Governments in specified National Health Protection Scheme (NHPS) announcement
ratio as per Ministry of Finance guidelines. The total by the Union finance minister in his 2018 budget speech.
expenditure will depend on actual market determined
premium paid in States/ UTs where Ayushman Bharat - NHPS has faced a mix of admiration and criticism from
National Health Protection Mission will be implemented policy makers, politicians, healthcare workers and
academics. Sceptics have raised questions on its contours,
through insurance companies. In States/UTs where the
scheme will be implemented in Trust/Society mode, the assumptions and implementation. Earlier, this author too
central share of funds will be provided based on actual had pointed out NHPS's limitation towards achieving its
expenditure or premium ceiling (whichever is lower) in the objective of "health for all" as it excludes coverage for
pre-determined ratio. Poor people will not fall back into outpatient services availed in the private sector by its
utter poverty due to a health emergency and they can be intended beneficiaries, the largest chunk of their out-of-
assured that the scheme will take care of their health needs. pocket expenditure on health.
The scheme is a game changer in the health sector and it Quality of healthcare delivery is another concern. In public
should be rolled out in a manner that ensures the best healthcare organisations, one finds well-qualified, over-
possible coverage. Private health and insurance industry worked, under-rested junior doctors and residents, who
experts also expect new jobs to be created. The scheme will tirelessly work in order to eventually land up a more
also create lakhs of new jobs in the country as new organized and better-paying job within India or abroad. The
healthcare facilities will come up in smaller districts and pitiable and unhygienic conditions in which they work and

The Insurance Times, August 2019 19