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Significance of AB PM-JAY in the light of COVID-19
Ayushman Bharat Pradhan Mantri Yojana (AB PM-JAY) is a scheme that has been recently discussed on the news in the light of COVID-19 after Prime Minister narendra Modi on 24th March, 2020 announced for an absolute lockdown nationwide. It has been suggested by official sources that the scheme may soon cover treatments related to the pandemic. The National Health Authority has decided to cover tests and treatment for respiratory ailments under AB PM-JAY and sought permission for the same from its governing body.
What is AB PM-JAY and what does it cover?
AB PM-JAY is a scheme launched by the Governemnt of India as a step to achieve the 3rd Sustainable Development Goal which deals with 'good health and well-being' and its underlying commitment to 'leave no one behind.' It was implemented on the recommendation of the National Health Policy, 2017 which aimed to achieve Universal Health Coverage (UHC)
As defined by WHO, Universal Health Coverage means that all people and communities can use the promotive, preventive, curative, rehabilitative and paliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
This definition aims towards 3 main objectives:
- Money should not be a hindrance in obtaining health services
- Quality of health services should not be compromised with
- The cost of such services should not put people at the receiving end in a financial risk
The objectives of UHC solely focus on the people receiving health services but it is the duty of member nations to plan schemes by creating a balance between the provider (Central or State governement) and the subject (the receiver), taking into consideration various socio-economic factors of the nation.
Although there are various health benefit schemes provided by Indian Central and State Governments, PM-JAY differs significantly and is comparatively wider in scope. It provides the benefit of cashless cover of up to INR 5,00,000 to each eligible family per annum for secondary and tertiary care conditions listed under it. These benefits enlisted could be used by one or all memebers of the an eligible family. Further, there is neither a limit on the number of family members nor on their age. Pre-existing conditions are also covered under the scheme from the first day itself. The scheme covers the following:
- Mediacal examination, treatment and consultation
- Pre-hospitilization
- Medicine and medical consumables
- Non-intensive and intensive care services
- Diagnostic and laboratory investigations
- Medical implantations (where necessary)
- Accomodation benefits
- Food services
- Complications arising during treatment
- Post-hospitalization follow-up care up to 15 days
As of now, the scheme is said to rely on the socio-economic caste census of 2011 and aims to cover over 10.74 crore families in vulnerable conditions.
