AYUSHMAN BHARAT TO SERVE MORE PEOPLE THAN US POPULATION:CEO

Ayushman Bharat, which has been designed to attain the ultimate goal of universal health care, is the world’s largest health care infra scheme, covering 500 million people or roughly 40 per cent of India’s population. The onerous task of spearheading the scheme was entrusted to INDU BHUSHAN, the former Rajasthan cadre IAS officer, who was recalled from the

Asian Development Bank for the purpose. Bhushan, who is the chief executive officer of Ayushman Bharat (also known as Pradhan Mantri Rashtriya Swasthya Suraksha Mission), speaks to Gina Krishnan about the massive pan-India roll-out. Edited excerpts:

It has been less than 100 days since you took up the task of setting up Ayushman Bharat. What is level of preparedness you have for rolling out the scheme?

The Cabinet has approved

the funding. It is true that we are working at a very fast pace. All the guidelines regarding the administrative verticals — state coordination, benefit packages, hospital empanelment, IT support, demand, and IEC as well as monitoring, among others — are in place. Positions are being advertised. One of the most important components is to get the software up and running. Tata Consultancy Services has the mandate as of now. It should be ready by the end of July with the first module on hospital empanelment. Field testing in some villages will also begin in July. The software will have a database of beneficiaries, empanelled health care providers, and state governments linked to the Ayushman Bharat site. The core software has modules on database of beneficiaries, hospital empanelment,

transactions and grievances, among others. MoUs with 23 states have been signed, and a few are expected in the next few weeks.

A lot has been done in terms of rolling out (the scheme) at the state level. States are at different levels of preparedness. Some already have ongoing schemes, so it is much easier for them to scale up. They just need to deepen what they are doing. Others, such as Uttar Pradesh, Bihar, and Madhya Pradesh, do not have any scheme — no structure, expertise or experience. They are populous states and so we have to work hard at providing resources and establishing a programme management unit which can help the states service the scheme.

National portability for us is the most significant part of the scheme and a core feature. Health care will be available to a beneficiary in any part of the country. So, states just need to add that and deepen what they are already doing.

Some states like Odisha do not want to join. Will they be independent providers of health care without joining the national programme?

Since health is a state subject, states have to choose how to provide services to the people. If they decide not to join because of technical concerns about the scheme, we can address and solve those, but if they are not joining for political reasons, then we cannot comment.

It is true that Odisha is not yet joining the scheme but we are still pursuing discussions with the state and have not given up. We want all states to be a part of the programme. When we talk about a national scheme that covers 500 million people, we want all states to be part of it so that we can all together move towards the ultimate goal of universal health coverage.

We will continue to have a dialogue with Odisha. Delhi signed last week, West Bengal is interested and Punjab, too, has indicated it will join. We are hoping that sooner or later all 36 states will join. But by end of July, we hope at least 28-30 will be a part of the scheme.

How was the enrolment done?

We do not call it enrolment because this is an entitlement-based scheme — it is identification or validation, because these people are already there and have been identified in the SECC database.

We have undertaken a drive in rural areas of 23 states and we have been able to identify and validate 80-85 per cent of the population in these states. In urban areas, our success rate has been 50-60 per cent. Beneficiaries will get an identification card, which can be downloaded on the mobile through an app.

The private sector is very concerned about the pricing...

The basic principle of the scheme is to cover the vulnerable segment of society — people at the bottom 40 per cent of the population. We want maximum benefit to go to them rather than to the medical profession or insurance agencies. We understand that hospitals or insurers have to be compensated or they may not participate. However, we do not want them to garner most of the benefits.

Secondly, Ayushman Bharat is a very disruptive scheme. We are expanding health care services for 500 million people. If it (this population) was a country, it would be the third-largest after China and India. In fact, the fourth-largest would be the US with its 300 million people.

It is a large market. We have to move cautiously so that our scheme remains sustainable and does not inflate costs.

A total of 1,350 packages with prices have been announced. For the first time in the country, an agency has been set up for strategic purchase of services. We are driven by evidence and science (when we arrive at a pricing package). A large number of providers from tier 2 and 3 cities are willing to come at these rates.

Read full interview on www.business-standard.com