Extension of the Ayushman Bharat scheme

Source: The post extension of the Ayushman Bharat scheme has been created, based on the article “Why extending national health insurance scheme to elderly is not enough” published in “Indian Express” on 18th September is 2024

UPSC Syllabus Topic: GS Paper 2- Governance-Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes

Context: The article discusses the government’s extension of the Ayushman Bharat scheme to cover older adults above 70 years. However, it argues that this is insufficient to fully protect against high healthcare costs, highlighting the need for better public healthcare infrastructure.

For detailed information on Expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) read this article here

What is the new extension of the Ayushman Bharat scheme?

1. The government extended the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to cover older adults above 70 years.
2. A Rs 5 lakh top-up is provided for those not covered by other public health insurance schemes.
3. It aims to benefit 4.5 crore families, addressing the healthcare needs of the elderly.
4. Only 20% of people above 60 years have health insurance, leaving many vulnerable.
5. The budget allocated is Rs 3,437 crore, but estimates suggest Rs 14,282 crore is required to cover 5.6 crore households, with an average hospitalisation cost of Rs 32,804 per person.

How does healthcare impact older adults in India?

1. India’s ageing population is increasing rapidly, with life expectancy at 70 years, but healthy life years are only 63.5.
2. Non-communicable diseases, disabilities, and bedridden conditions are prevalent among those aged 70-80 and 80-plus.
3. Only 20% of people above 60 have health insurance, leaving the elderly highly vulnerable to healthcare costs.
4. Out-of-pocket spending for inpatient care is twice as high for the elderly compared to younger people.
5. Nearly half of Indian households seeking hospitalisation experience catastrophic healthcare expenditures (CHE), with 15% falling into impoverishment.
6. The financial burden is worsened by high premiums for private health insurance for older adults.
7. The nucleation of families and rising economic dependency increase the vulnerability of older adults, making access to affordable healthcare critical for this population group.

What are the concerns related to the extension of the Ayushman Bharat scheme?

1. Inadequate Budget Allocation: The government allocated Rs 3,437 crore, but Rs 14,282 crore is required to cover 5.6 crore eligible households, with an average hospitalisation cost of Rs 32,804 per person.
2. Limited Coverage: AB-PMJAY covers secondary and tertiary care but excludes outpatient services, which account for 46% of healthcare spending and are critical for preventive care.
3. Public Healthcare Spending: India’s public healthcare spending has remained stagnant between 0.9% to 1.35% of GDP, limiting the healthcare system’s ability to support ageing populations.
4. Long-term Care: The scheme doesn’t cover long-term and palliative care, crucial for elderly patients with chronic diseases.

Question for practice:

Evaluate whether the extension of the Ayushman Bharat scheme adequately addresses the healthcare needs of India’s ageing population.