Ayushman Bharat, the new, flagship health initiative of the government, has two dimensions. First, it aims to roll out comprehensive primary health care with Health and Wellness Centres (HWCs) serving as the people-centric nuclei. A nationwide network of 1.5 lakh HWCs will be created by transforming the existing sub-centres and primary health-care centres by 2022. This will constitute the very foundation of New India’s health care system.
So far, the country’s primary health care has been focussing on reproductive, maternal health, newborn and child health as well as controlling priority communicable diseases. All this perhaps covers only 15% of our needs. Public health action for preventive/promotive health has also been limited. There is a huge unmet need for primary health care, namely, care for non-communicable diseases (specifically, prevention and early detection and treatment of hypertension, diabetes, chronic obstructive lung disease, and common cancers), mental health, care of the aged, adolescent health, palliative health care, basic eye care and dental health.
If we build a strong, robust next generation primary health-care system, it will save lives and will lead to a healthier India. For instance, detecting and treating diabetes from the age of 35 years by a screening test would avert kidney failure at 50 years in case the condition remains undetected and untreated.
The government has committed for two-thirds of resources to go into a comprehensive primary health care as part of the National Health Policy 2017. The HWCs are somewhat on the lines of the U.K. general practices health system, but run largely by nurse practitioners and trained health workers, which are accessible near home.
Prevention and positive behaviours are the key to good health, productivity and a long life. Healthy families, villages and cities is the goal of the primary health-care system. HWCs will help unleash a people’s movement for a healthy India.
Providing insurance
The second dimension of Ayushman Bharat is the National Health Protection Scheme which aims to provide health cover of ₹5 lakh per family per year for hospitalisation in secondary and tertiary care facilities. In one go, given the ambitious size of the package, 40% of people, neonates to young and old, will have access to facility care for almost all the medical and surgical conditions that could occur in a lifetime. The programme will cover half a billion people and would align with what the State governments are doing already, with significant resources coming from the Centre. Many State governments would extend the benefits to additional beneficiaries through their own resources so that ultimately the population covered for catastrophic expenses could be two-thirds of India’s population, if not more. This mission enables increased access to in-patient health care for the poor and lower middle class. The access to health care is cashless and nationally portable. The scheme would enable a weaver in a remote village to be able to walk into a hospital for a gall bladder stone surgery or a coronary stent without having to pay the hospital. Treatment will be provided by empanelled public and private hospitals. Private hospitals will have to agree to terms such as package rates, adherence to standards and guidelines, ethical practice, respectful care and client satisfaction, and transparency.
Ayushman Bharat will spur increased investment in health and generate lakhs of jobs, especially for women, and will be a driver of development and growth. It is a turning point for the health sector.
