‘We are moving towards universal health cover’
Prime Minister Narendra Modi will launch the Ayushman Bharat scheme on September 23 in Ranchi, followed by the nationwide launch of his government’s flagship health insurance programme that aims to provide ₹5 lakh hospitalisation cover to up to 107.4 million poor and vulnerable families. How prepared is India for the rollout? Union health minister JP Nadda tells
why he is confident about the programme being on track, and how the remaining challenges will be overcome.
Sanchita Sharma
The programme gives health insurance coverage to 107.4 million families and more than 550 million people. As it will be digital, paperless and cashless, we have got the best in the field of IT on board. There are three financing models — insurance model, trust model and hybrid model— and 19 states have chosen a trust model. The letters with individual QR codes are being printed and will start getting distributed. Around 10,000 ‘Arogya Mitras’ from empanelled hospitals are being trained by the National Skill Development Corporation to act as an interface between patients and hospitals. Individual beneficiaries will take letters with QR codes to an Arogya Mitra at the hospital to get a card with the names of all the family members. Around 80% of the identification process in rural areas and 70% in urban areas are complete. This week, ANMS (auxiliary nurse midwife, a village-level health worker) will start distributing the letters.
Doctors can prescribe 1,350 procedures and packages and, after a patient is admitted, treated and feedback taken, the payment will be done within 15 days of the patient being discharged. are on the list or not, and then people will go to Arogya Mitras. That’s when the discussions will start. In a medical emergency, you can get pre-approval for procedures. If the approval doesn’t come in half an hour, it is deemed to be approved.
There are 94 types of automatic checks in the digital system that will set off alarms if it detects aberrant data. There will be social audits. We will also learn as we go forward.
Data security of international standards has been maintained. We did not have SOPS (standard operating procedures) for it in India, so we have adopted international SOPS as our own. This is the first time such data security systems are being used in India. Private hospitals follow security, but they don’t have standardised data protection procedures. is coming on board the day after tomorrow (September 13). Kerala is still dealing with the floods. Punjab is going to come, Telangana is on board. They know their minds best, but I will appeal to them time and again (to come on board). Today (September 11) I appealed to Delhi again. People should get the benefits. I also said this to Naveen Patnaik ji. We also have gradation — a hospital and a nursing home can’t have the same payment system. As services improve, the packages go up accordingly. Ayushman Bharat is applicable for district hospitals and above. It is for lifesaving procedures in hospitals with the capacity to do it. We have projected to have 150,000 health and wellness centres by 2020. There is a road map. At this point, 2,500-plus are ready, and by the end of the year, we will cross 10,000. Next year, we’ll add 40,000 and keep scaling it up. The reason why it is 10,000 to 15,000 initially is because manpower is being trained. Once we have trained staff and more trainers, we will scale up. within 15 days. We have to give penalty if the payment is delayed beyond 15 days.
It will be according to the rates. The NHA will decide, but all payments have to be made within 15 days, so budget is no issue. It will increase after this. You see, when health coverage expands so much, it will automatically go up. As needed. The way it works is, we write to the finance department and we get it. The finance minister has openly said that whatever you need for it, you’ll be getting it. Every week. All details, all presentations are discussed — how will it be rolled out, what are the systems being used.
We need to strengthen IT to roll out a programme on such a big scale. The data has to be absolutely correct. People spell their names in different ways. Prakash may be spelt ‘Parkash’ or ‘Prakash’. Balvinder may be spelt ‘Balvindra’. We have to get the right person, and IT has to catch that and use that QR code to also include the family members. They are working very hard. Once you have the common man with ₹5 lakh support for treatment, hospitals will come up. And with hospitals, doctors will come.
The changes will happen in tier-two and tier-three cities, where more hospitals will open.
Doctors, who work in large hospitals, will become mobile and visit different hospitals in other towns on different dates and days. They will visit, operate, and come back.
There is portability. Where there are no hospitals, people will go to other places for surgeries, like they are doing today.
But today they don’t have money; tomorrow they will have money.
And when the money stays in hospitals, they will use it to consolidate and develop infrastructure and capacity. The free drugs and diagnostics supply chain is being made more robust. We are using It-enabled systems to monitor medicines stocks in community health centres (CHC), primary health centres (PHC) and sub-centres to ensure stocks don’t run out. Under free drugs and diagnostics, around 50 types of drugs and five tests are being done at PHCS, more than 100 drugs are available at CHCS, and more than 600 drugs at district hospitals. It will all be digitally managed. The Centre has assisted states with more than ₹16,000 crore over four years for drugs and diagnostics. Complaints can be made online and offline to the state health agency and within 15 days, they need to submit the report. It is a major step towards it.
On the one hand, it takes care of the secondary and tertiary health of the poor, vulnerable and marginalised, and on the other, it offers universal health screening of cervix cancer, breast cancer, oral cancer, hypertension, diabetes, tuberculosis and diabetes. Then we have free drugs and diagnostic facilities for all. When universal screening begins, it becomes universal health coverage. We are on track. NEWDELHI: The Congress on Sunday accused the Telangana Rashtra Samithi (TRS) government of trying to vitiate the assembly polls by “manipulating” voters’ lists, and sought the Election Commission’s intervention in verification and sanitisation of electoral rolls.
“The TRS dissolved the Telangana assembly prematurely to swing elections in their favour by manipulating and contaminating the voters’ list,” said Congress spokesperson Abhishek Manu Singhvi at a news conference.
“Any election held on the basis of these deeply and deliberately flawed and inaccurate voters’ list would undermine the entire process and would lead to a distorted mandate. It would be a fraud on democracy and on the people of the country,” he said.
Accompanied by senior Congress leader from Telangana M Shashidhar Reddy, Singhvi said the move will not only further deepen the doubts of the common electorate in the electoral process, owing to such glaring anomalies, but further erode the faith that the people of this country need to have in the institution of the Election Commission.
Singhvi claimed that there were around 70 lakh discrepancies in the voters’ list in Telangana. Out of those, names of over 30 lakh voters were duplicated and 20 lakh deleted on the pretext that they have left for Andhra Pradesh, he added.
“But the same have not been added to the voters’ list of Andhra Pradesh. Besides, the names of around 18 lakh voters were found in the electoral rolls of Telangana and Andhra Pradesh,” the Congress leader said.
The Congress is likely to move the court to ensure that the alleged discrepancies and anomalies in the electoral rolls are corrected before the elections . The party has already moved a petition in the Supreme Court on the alleged discrepancies in electoral rolls in poll-bound Rajasthan and Madhya Pradesh.
Singhvi said the Congress has demanded that thorough process of verification and sanitisation of the voters’ list be initiated before the elections are announced.