The Indian Medical Association (IMA) said government hospitals should be removed from the ambit of the Centre’s ambitious Ayushman Bharat health insurance scheme, as services there are already free of cost.
IMA National President Santanu Sen said if the government wants to fund public hospitals they should do so directly.
“Why should it be done through insurance companies by paying 15 per cent to them,” he said while demanding that the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) be restricted to the private sector. “There is no additional benefit accruing to people by including government hospitals in AB-PMJAY as services in public hospitals are free already,” Sen said.
The IMA has come out strongly against the current structure and mode of implementation of AB-PMJAY, alleging that the insurance model of healthcare delivery is a failed one.
Universal health coverage
India should not continue the insurance route for healthcare delivery as the administrative cost and the “unholy nexus” with insurance companies point towards profit maximization rather than quality health care delivery, an IMA member said.
IMA Secretary General Dr RV Asokan said fragmented approach to healthcare will not bear fruit and demanded “tax funded” universal health coverage rather than the “for profit” insurance model.
“The Insurance Regulatory and Development Authority (IRDAI) has no concept about the healthcare needs of the people and should be kept away from formulation of any policy or standards,” he said.
On the government deciding to “name and shame” hospitals found involved in fraudulent practices in the Ayushman Bharat scheme, Asokan said, “The negative approach of the government to name and shame hospitals has been borrowed from the ‘for profit’ insurance companies and the dehumanized approach of IRDAI.”
According to the National Health Authority, the apex body responsible for the implementation of the centrally-sponsored scheme, the decision to publicly name health insurance fraudsters under Ayushman Bharat was taken in collaboration with the IRDAI to deter them from indulging in malpractices.
“The government should come out with a transparent and fair costing system, eliminate the insurance companies, restrict AB-PMJAY to purchase of care from private sector for well-defined economically and socially marginalised people over and above what is provided by a robust public sector,” Asokan said.
“The government should strengthen public hospitals by way of infrastructure and human resources.” he said.