Ayushman Bharat: out of reach

Health National policy

People in need of emergency healthcare face a hard time getting Ayushman cards issued.

Lucknow: Salma, a resident of Lucknow, has made several attempts along with her husband to get their Ayushman Bharat card made. Yet, they haven’t seen any progress so far.  

Salma, now a mother of a four-month-old daughter lives in a slum of the city with her family and works as a house help for three families. She said that every time she or her husband went to look for guidance for registration under the Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB PM-JAY) scheme, they came back with several rejections. 

After a certain point, the couple stopped making efforts to get the card and decided to deliver her baby at home as she did not have any medical complications in her pregnancy. On January 27 this year, Salma gave birth to a healthy girl at home. Both mother and daughter did not get any medical assistance as they could not afford to visit a hospital without an Ayushman card.

Not being able to pursue a card puts both the health of the mother and child at risk as they won’t visit a hospital without it.

Ayushman Bharat is a government scheme launched in 2018 by the Prime Minister and promises to cover about 10 crore families and 50 crore beneficiaries in total.  The scheme will provide a health cover of Rs. 5 lakh per year, and the money could be used by all members of the beneficiary family. The scheme covers primary, secondary, and tertiary treatment of the beneficiary, and promises to cover three days of pre-hospitalisation and 15 days of post-hospitalisation expenses of the patient.   

Suman Yadav, who works on the ground level in affiliation with a government hospital, said, “We have organised several awareness programs to help the people in need and identify beneficiaries. But, for us to help them with the issue of the card, they need to cooperate too.”

 “Merely five percent of the beneficiaries listen and follow the steps told by our staff properly. We have Accredited Social Health Activists (ASHA) workers around the rural areas who update the residents about the camps that we hold for issuing the golden card. Yet, some unavoidable situations occur like errors in the spelling of the name of the applicant or Aadhar number discrepancy on the system. All these reasons prevent the said beneficiaries from getting the card,” she added.

Varunesh Mishra, an Internal Revenue Service (IRS) officer from the National Health Authority (NHA), said, “The eligibility criteria of the people is the main issue that comes in the way of getting registered for the scheme. According to our database, nearly 12 crore families and 60 crore beneficiaries stand eligible for the scheme. The eligible people are chosen based on two things– one, people who are already registered for the Rashtriya Swasthya Bima Yojana (RSBY) which is a similar scheme that worked before Ayushman, and two, the Socio-Economic Caste Census 2011 (SECC).”

The Ayushman golden card application requires the aadhar details of the applicant and his family.

“The people who are already registered in the database are easily eligible for getting the card. Yet, only 14 crore people have been registered so far in our system as beneficiary onboarding remains a major issue. The second problem occurs when the beneficiaries don’t avail of the scheme. Out of the 14 crore beneficiaries, two crores have already been treated under the scheme,” he added.

Dr. Anjani Singh Sisodia, a homoeopathic doctor and a public health expert, said, “The monitoring of the scheme is very necessary in such crucial times. Some beneficiaries actually need help but cannot get it, while  others fraud the scheme. In these times, the needy can only turn towards private hospitals as the government hospitals have turned into covid centers. Many private hospitals make fat bills to extract money from the government.”

He added, “There have been instances when these private hospitals register a disease way bigger than it actually is. They print expensive bills in the name of the treatment of the patients, which is way more than the actual cost of the treatment, and extract money from the government under those bills. These steps need to be monitored closely by the government. Only close monitoring can help the scheme grow and reach every person who needs it.” 

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