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In the next two-three years, government health cover will become a reality for every Indian.
According to National Health Authority (NHA) officials, the Pradhan Mantri Jan Arogya Yojana (PM-JAY), popularly known as Ayushman Bharat, which currently covers 40 per cent of the population, is likely to be extended to all citizens.
NITI Aayog, in its latest report, has rued duplication of government health schemes. It wants multiple health schemes brought under one umbrella scheme.
“Taking a cue from the NITI Aayog report, universal health coverage in India will become a reality in the next two-three years. Implementation authority will most likely be the NHA, as it makes little sense to create a separate authority as we already run PM-JAY,” PM-JAY CEO Indu Bhushan told BusinessLine.
Currently, PM-JAY provides cover worth ₹5 lakh annually for 10 crore families, or 50 crore individuals, for treatment in a public or private hospital.
According to officials, while 50 crore persons are under PM-JAY, another 20 crore persons get the benefit of State schemes, with 100 per cent cover, and 13-odd crore persons come under Employment State Insurance Corporation (ESIC) scheme. And then there is Central Government Health Scheme (CGHS).
“All in all up to 70 per cent of the population is already covered; the rest 30 per cent that are excluded are tax-paying citizens and those working in the private sector,” said a senior NHA official.
The official added that the NHA had already started inching towards bringing different schemes under one umbrella, by making PM-JAY available in ESIC hospitals. “Intwo to four months we will make sure that PM-JAY is extended to all CGHS claimants,” the official said.
The NHA is waiting for a political nod to extend PM-JAY across the country, the officials said and indicated that the model for the taxpaying citizen may be slightly different, with a modest premium deducted for extending the cover.
“This may or may not be the case... at this stage as we await orders, all possibilities are conjectural,” said the officials.
Currently, not all private hospitals especially the big chains are part of PM-JAY. Most upper-middle-class patients go to private healthcare providers because of overcrowding in government hospitals. Also, whether participation in the scheme will be voluntary or not has not yet been decided. “We will have to sort out the nitty-gritty of the scheme once we are directed to chart out a plan for universal health coverage,” said the official.
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