| Introduction: Contextual Introduction Body: Significance of AB-PMJAY for senior citizens & challenges in this new program. Conclusion: Way forward |
The government’s decision to extend the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to senior citizens above the age of 70 marks a significant step toward universalizing healthcare in India.
Significance of Expanding AB-PMJAY to Senior Citizens
- Enhanced Healthcare Coverage: Currently, only 20% of the elderly are covered by existing safety nets like the CGHS, Rashtriya Swasthya Bima Yojana, and employer-funded schemes. The extension of AB-PMJAY will address this gap by covering a large number of senior citizens who are not otherwise insured, promoting financial security and access to medical care for this vulnerable age group.
- Addressing Out-of-Pocket Expenditure (OOPE): India’s high OOPE on health, which constitutes 50% of all health expenses, is a key driver of poverty, particularly among senior citizens who often face chronic health conditions. By reducing their financial burden, AB-PMJAY can protect elderly individuals and their families from the economic shock associated with healthcare costs, thereby contributing to poverty alleviation.
- Longevity and Growing Healthcare Needs: With rising lifespans, the elderly population will demand more healthcare services in the future. Expanding AB-PMJAY offers a foundation for long-term healthcare planning for an aging population, particularly for age-related diseases like diabetes, cancer, and cardiovascular issues.
Challenges in Ensuring Quality Healthcare for the Elderly
- Access and Infrastructure Gaps: Ease of access and quality of care are critical for senior citizens, but a shortage of healthcare facilities and geriatric specialists hampers effective service delivery.
- Misuse and Inefficiency: Reports have shown instances of doctor malpractice and misinformation of patients, where hospitals bypass AB-PMJAY benefits or make it difficult for patients to claim them. There is also evidence that overburdened hospital staff often fail to facilitate the insurance process, causing delays and frustration for already stressed families.
- Doctor-Patient Asymmetry: The asymmetry in doctor-patient relations adds complexity to the smooth implementation of AB-PMJAY. Many patients and families are misinformed about the scheme, which exacerbates delays in accessing benefits. While some hospitals employ arogyamitras to counsel patients, their role is often limited to registering claims.
Conclusion
The expansion of AB-PMJAY to senior citizens is a crucial step in providing universal healthcare in India. However, to address the challenges of a rapidly aging population, the government must focus not only on financial coverage but also on improving healthcare infrastructure, ensuring accountability, and empowering support staff to better assist elderly patients.
