While India is slowly easing its lockdown restrictions, the number of Covid-19 cases remains on the rise. Receiving adequate and on-time treatment, apart from monetary and other associated concerns have gripped large sections of the populace, particularly the migrants and the poor. In a conversation with CNN-News18, Dr Indu Bhushan, chief executive officer (CEO) of Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB–PMJAY) and the National Health Authority (NHA), underscores the benefits passed on by the scheme so far to those hit by the pandemic, key features of the programme such as portability, and the challenges that remain.
Q: 1 crore beneficiaries of PMJAY, and counting, for you to be associated with this programme for close to 2 years now, how did you achieve this ?
A: This shows there was a lot of pent up demand. A lot of people needed the support. We are glad we could deliver. Linking 50 crore beneficiaries with more than 21,000 hospitals in 32 states and union territories was never easy. But with the strong IT framework, we could achieve it. This is the beginning.
Q: Portability is a big advantage of Ayushman Bharat. How are you going to help migrants, who are moving back to their villages, get the benefits of the programme?
A: You are right. We are proud of the portability. Many schemes in different parts of the world didn’t have this portability advantage. This process is complex. And we could achieve this because of the background. It is a big service for those who are moving to their villages. We will be counselling migrants, making them aware of their rights and benefits. They will still have the cover when they move around. More than 1 lakh portability cases have been provided.
Q: Tell us how Ayushman Bharat is serving the people to get access to Covid-19 care?
A: Any beneficiary won’t have to pay in any empanelled hospital. More than 2,000 Ayushman beneficiaries have received free treatment under the scheme for Covid-19. And testing free for more than 3,000 beneficiaries. Right now the system is able to take care of patients, but when there is a surge the public system may not be able to help. That’s when Ayushman Bharat will be important.
Q: Hospitals say you don’t provide reimbursements on time. Is that the biggest hiccup?
A: No I don’t think so. Private hospitals have not told us about this. The payment is timely. More than 85 per cent of payment is done within 15 days. We have heard that our rates are not viable. The rates are actually based on a regression analysis.
Q: Are you expanding the coverage of the scheme, because the pandemic shows more and more people need not just affordable but free healthcare?
A: The aim is to consolidate right now. If we can provide quality services to those 50 crore people, then we will be moving to other groups .
Q: Will you be looking at giving benefits to healthcare workers under the scheme since the government has given them insurance now?
A: We are for including many groups, like ASHA workers and Anganwadi workers. Any group the government decides to include we will be happy to cover.
Q: With the current pandemic exposing many poor and vulnerable groups needing financial protection against ill health, are there any plans to expand population coverage?
A: This is a pertinent point. Because of Covid-19, our footfall in hospitals has gone down. We were doing 25 to 30 thousand treatments before the lockdown. This has gone down to 12 to 15 thousand. The drop for critical care has been about 15 to 20 per cent. People are scared to come to hospitals. Many hospitals have converted to Covid-19 hospitals. Some hospitals have closed down because they feel it is not viable to run them now. We have to look into this. There is contraction in services and demand.
Q: While PMJAY is entitlement based with no formal enrolment process, yet only 25% have been registered for availing benefits from the programme over the past 1.5 years. Are there plans to accelerate registering the target coverage?
A: People can come even without cards. Giving them a card gives them surety. We will be expanding this process of giving cards and improve enrolment when the lockdown is over.
Q: What is the biggest hiccup that's preventing you from expanding the scope of the scheme?
A: The government is committed to providing universal health coverage. It is a question of stages. You can look at expanding a scheme without looking at lessons learnt. We provided cards to over 12 crore beneficiaries. 75 per cent of the beneficiaries don’t have cards. Small steps are better than leaps.
Q: Which states are doing very well under the scheme?
A: I don’t want to single out states. I am saying sincerely most states have done well. Some states like UP and Bihar didn’t have any scheme and have done remarkably well. Some states converged their scheme with ours. We had RSBY going and they had experience and they have done well. Gujarat and Chhattisgarh have done well. Even Rajasthan. Punjab has done well. They have recently joined. Jammu and Kashmir, in spite of the tough times it has gone through, has done very well.
Q: Your personal interventions with Delhi, Telangana, Odisha and West Bengal have been ongoing. They are still not on board.
A: Delhi is coming on board. Within a week. Odisha, we are trying. It will benefit people from the states. Even if they have a scheme they can merge it with Ayushman Bharat and improve their existing ones. You can take the benefits by joining Ayushman Bharat like national portability. West Bengal was on board. They were a part of the scheme and for some reason opted out. We hope they will join back.