Ayushmaan Bharat—A Gamechanger Health Insurance Scheme for All From “NAMO CARE”, Leading India towards Healthier Nation on Planet Earth - The Fearless Indian
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Ayushmaan Bharat—A Gamechanger Health Insurance Scheme for All From “NAMO CARE”, Leading India towards Healthier Nation on Planet Earth

  • Sukanya Iyer
  • March 24, 2018
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As Swamy Vivekananda Rightly Says “You must all pay Attention to your Health First”.

As I Write another Positive Blog envisaging Our Government of India’s Pro-Vikas agendas directed towards empowerment by addressing their Grievances & Miseries.  This Blog will bring out much talked “NamoCare, An Initiative which will take Healthcare to scale to a greater Height of Aspirations of 1.25bn Indians. Finance Minister, Mr. Arun Jaitley while Presenting the Union Budget 2018-19, stated“we are now launching Flagship National Health Protection Scheme to cover 10cr poor & Vulnerable families.This is approximately tertiary care for Hospitalisation.”   He Emphasised that this Particular Initiative would take Health Care Protection to a new aspirational Level. This Initiative was Part of “Ayushman Bharat”. It will be Provided with adequate funds for its smooth Implementation. “This was aimed at making Path-breaking interventions to address Health Holistically, in Primary, Secondary & Tertiary care Systems, covering both prevention & Health Promotion”. Said Mr. Arun Jaitley.

Friends, let me Tell you what is Ayushman Bharat & its Salient Features

Under Ayushman Bharat, the Government has also decided to Fund Rs. 1,200 Cr. For 1.5LHealth wellness Centres across the Nation. Main aim of this huge Decision was to convert the Primary Health Centres into wellness centres was taken in last Fiscal Budget (2017-18). However, the money was not allocated to it. The Name was given by Healthcare Industry which termed the Government’s National Health Protection scheme as an out of the box idea, saying that it will emerge as a boon for the beneficiaries. According to Ayushman Bharat, this National Health Scheme will go a long way to achieve the goals of Universal Health Coverage. Mr. Arun Jaitley as Part of the Union Budget (2018-19), also announced Huge Package for Nutritional Support of Tuberculosis Patients of Rs.600Cr. Another Important announcement was made during the Budget session was that of, total of 24 New Government Medical colleges was also announced as part of the new Initiative taken by the Government.

Key Takeaways—

There will be No cap on the size of the family which will be covered as part of the National Health Protection Scheme which is Launched as Part pf “Ayushman Bharat, which will be implemented on October2nd, the Birth anniversary of Father of the Nation Mahatma Gandhi. The Health Insurance Scheme, according to the Budget which has set its goalpost as 10cr families or between 40 to 50cr. Citizens—roughly 40% of the total Population. Most important or rather Key Takeaways, is that of under this scheme, Free Health Insurance of Rs.5L which will be provided every year to those who fall below the Poverty line or BPL families. Niti Aayog which has been roped in by the Government, clearly stated the fact that an annual Premium as part of the mega Health Insurance Scheme would be in the range of Rs. 1,000 –1,200/ Family, which will be borne by the Government itself. There will be 60 & 40% shared between Centre & State respectively. The overall, estimated cost for Exchequer between Rs. 10,000-12,000Cr. The most Striking Point is that the process to avail this Particular scheme is Cashless & Paperless, key requirement would be of only Aadhar Number to Enrol in to this Policy.

This is one of the world’s biggest Health Care Programme. The Government said it has provided for adequate Funding with an additional 1% Cess imposed in the Budget on Income Tax.  Hasmukh Adhia, Finance Secretary Said, “It is for this that we have put 1% extra cess, that will give us Rs. 11,000cr. The Programme which will cost about Rs. 10,000 Cr. with the share of the Central Government being about Rs. 4,000 -5,000 Cr., as it will be shared with the States too, Said Economic affairs Secretary Subhash Chandra Garg based on his Interaction with the Health Ministry. He also further went on clarifying, what the programme holds & also clarified Government’s standpoint that the Financial Burden won’t be added on to the Government.

Mr. Garg also further stated the fact that “This scheme is for hospitalisation for Major diseases & there the Track record of the Rashtriya Swasthya Bima Yojana, also has been taken into consideration, by the Health Ministry. He also further stated the fact that “In that sense, it doesnot appear to be very heavy on the fisc”. Government’s Think-Tank-NitiAayog, estimates the Premium per family at Rs. 1,000 -1,200, which Translates into Rs. 10,000-12,000cr., for the full roll out of the scheme to cover over 100 Million Families.

It is also estimated that in the first year, only 505 of the beneficiaries, identified using Socio-economic Caste Census (SECC) data, will be shared between the centre & the States in a 60:40 ratio,90:10 for the hill sates. This NHIY (National Health Insurance Yojana). Provides Rs. 30,000cr., cover to about 36Million Poor families. Against an allocation of Rs. 1,000 Cr., last year, the revised estimate is seen at Rs.470Cr. NAMO Care, Mr JP Nadda, said that it would not only rely solely on Private Health Insurance Firms but that States could also opt for a Trust model. SECC data will be used to choose Beneficiaries, Minister clarified.There will be challenges for any Policy which is new to be implemented-Though Resources are not a constraint, and also enough Funds, but challenge is to create an Efficient Cadre of trained people to cater services at all levels of Health care. Mr. Adhia said “We have to first sort out the Procedural Modalities”.

Cabinet Approves Launch of Ayushman Bharat—National Health Protection Mission.The Union Cabinet Chaired by PM Modi approved the Ayushman Bharat National Health Protection Mission (AB_NHPM), on Wednesday, 21st March 2018, that aims to Provide Health Insurance to about 10.7 cr. Families which will be from Poor & Vulnerable Populations. This Program is intended to address the concerns that in-patient hospitalization expenses in India have increased 300%, over the past 10 years, & nearly 80% of this expenditure comes from Household’s Personal, or out of- Pocket Spending. The Government Through this Mission, will significantly reduce out-of-pocket spending on Health by Providing the Rs.5L cover to nearly 40% of the Population, paying for almost all diseases requiring secondary & Tertiary care. The Government also clarified that “To ensure nobody is left-out, there will be no cap on Family size & age in the scheme.The benefit will also cover Pre-& Post Hospitalization expenses.All pre-existing conditions will be covered from day one of the Policy. A defined Transport allowance per hospitalization will also be paid to the beneficiary,I feel this is total Health subsidy for all, which every Indian will heave a sigh of relief.

Under This Scheme families may seek Hospitalization services from Public &Private Hospitalsanywhere in the country which is empanelled by the government of India. The eligibility will depend on Households deprived on all levels.  In Rural areas, for instance, families with only one room with Kucha walls & Kucha roofs, Families with No adult members between ages 16 to 59years, female headed households with no able- bodied adult members, SC&ST households, & landless Labourers, that derive most of their income, from Manual Casual Labour will be covered. In Urban areas, families in 11 occupation categories will be covered in the scheme, the note said without listing these occupations. Households, without shelter, destitutes, & those living on alms, manual scavenger families & Primitive Tribal groups in Rural areas.

Most Importantly States would need to have State Health Agency (SHA) to implement the scheme. The States will have the option to use an existing trust/Society, Not for Profit company, or a State Nodal Agency to implement this Particular scheme. At District level too, there will a structure needed for implementation of the scheme to be set up.  Another Important & Transparent manner of Transferring funds—To ensure that the funds reach on time, transfer of funds from central Government through AB-NHPMA to State Health Agencies may be done through an Escrow account directly.The state has to contribute its matching share of Grants within defined time frame. For this Government has roped in Niti Aayog, a robust, modular, Scalable, & also an IT Platform which will be made operational which entail a Paperless, cashless, transaction. This will bring down corruption level, Misuse of Funds. There will be Organized Grievance Redressal mechanism. In order to ensure that the scheme reaches to the masses, there is a comprehensive Media & Strategy outreach which will be developed, which will include All Media Platforms, traditional Media, Outdoor Hoardings etc.

This Yojana is very Revolutionary, Gamechanger, very ambitious, indeed very aspirational too, it aims to target about 10.74 cr. Poor, deprived rural families & Identified occupational category of Urban workers, as per SECC (Socio-Economic Caste Census) data covering both rural & urban. AB-NHPM will be implemented across all over States, Union Territories, in all districts with only aim to provide Health Benefits to all the beneficiaries. The Scheme Will Integrate two schemes—Rastriya Swasthya Bima Yojana (RSBY), Senior Citizen Health Insurance Scheme (SCHIS).

Friends, Ayushman Bharat, A Positive, Transformative, Progressive, Vibrant, Yet Inclusive for Common Man who was deprived of all Health Benefits with reduced rates yet receiving world-class Medical Facilities, in this day & E-age, where Medical Facilities though on the rise, but Affordability is the biggest Issue. AB_NHPM which will Provide cashless benefits from any Public/Private Hospital across the country. For Effective Policy Implementation, Co-ordination between Centre & States, Ayushman Bharat, National Health Protection Mission Council (AB-NHPMC) will be set up at apex level.It will be chaired by union Health Minister & Family Welfare Minister.

Thank You PM Modi for Instituting & Implementing such an Effective Policy towards 1.25bn People of India. “Health Subsidies for all” — This will foster its way for creating A Healthier Nation On this Planet Earth. “Swasth Bharat, Surakshit Bharat which will pave way for “Akhand Bharat, Shrestha Bharat”.  I feel there has been lot of Noise created against our Government & on our Leadership, one thing I would like to opine by saying that, Friends, here is a Leader who hasn’t taken a Single day as Holiday for himself rather worked Tirelessly, Selflessly for Bharatvasis, lets collectively Support his Honest Intent & clear Convictions for Sabka Saath Sabka Vikas. With You PM Modi in all your Positive Endeavours Towards Nation Building.

Jai Hind

Dr. Sukanya Iyer



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