Expanding Ayushman Bharat Senior Citizen Health Insurance | UPSC Editorials

Recently,the Union Cabinet has expanded the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to provide health coverage to all senior citizens aged 70 years and above. Similar schemes have been implemented in various other countries such as Obamacare in the United States of America (USA). The expansion of Ayushman Bharat Senior Citizen Health Insurance scheme is important as India has an added advantage of demographic dividend but slowly the population is aging and thus need affirmative actions for supporting the needs and requirements of this particular section of the society.

Right to health is a fundamental right under the Article 21 of Indian Constitution and thus it is the duty of the state to provide quality healthcare facilities to the people especially vulnerable sections of the society such as Scheduled Caste (SCs), Scheduled Tribes (STs),PVTGs, Women, Senior citizens etc. 

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Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

This scheme was launched with much fanfare in September 2018. The scheme aims to offer medical coverage of INR 5 lakh per family per year for covering secondary and tertiary care hospitalization costs to poor and vulnerable families. This scheme is important as it covers nearly 40% of the total population of India. 

The target of AB-PMJAY scheme is targeted to cover 10.74 crore poor households who cannot afford to have quality healthcare treatment and thus get trapped into a vicious cycle of poverty. Government through this wants to create a healthy workforce in India which can propel its economic growth and prosperity.

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Benefits of Ayushman Bharat Senior Citizen Health Insurance Scheme

Ayushman Bharat senior citizen health insurance scheme provides a robust complete cashless access to quality health care services across a range of hospitals and medical facilities for the beneficiaries at the point of service, i.e., the hospital. It offers different sets of health benefit packages which cover health services such as surgery, day care treatments, cost of medicines and diagnostics. 

Role of National Health Authority (NHA) in Ayushman Bharat Senior Citizen Health Insurance Scheme 

The agency called National Health Authority (NHA) has been tasked to streamline process and policy related issues of the scheme. It is said that merely formulating a good policy on paper is not enough, its implementation is equally important. These are some of the task which the NHA has been assigned:

• To devise strategy for effective functioning
• Building a robust technological infrastructure
• Implementation of National Digital Health Mission (NDHM) to create a National Digital Health Ecosystem. 
• To implement the Ayushman Bharat senior citizen health insurance scheme at the State level
• Establishing coordination with State Health Agencies (SHAs)

Status of Ayushman Bharat Senior Citizen Health Insurance Scheme 

Experts and common people of India have appreciated this transformative move of the government as this expansion is going to bring a transformative change in the society. It is to be noted that India is a welfare state as stated in the Directive Principles of State Policy (DPSP) under Part IV of Indian Constitution. 

The extension of this scheme which will now cover all citizens aged 70 years & above is also going to add a new chapter in the development journey of the insurance sector in India. This expansion is expected to benefit an additional 6 crore elderly people from 4.5 crore families. 

Benefits of Expanding Ayushman Bharat Senior Citizen Health Insurance Scheme

The Government of India in its full wisdom has tried to address an emerging issue of rising violence against senior citizens. It has been observed that senior citizens are exposed to domestic violence by their own family members. Family members often treat senior citizens as a burden on their finances. Thus, this proactive measure by the government will help senior citizens to access quality healthcare which will be easily accessible as well as affordable. These are the following benefits of this expansion of senior citizen health insurance scheme:

• This expansion is going to provide substantial relief to an often neglected vulnerable section who face struggles with managing disease burdens without a reliable social security net. 
• This move is sine qua non for India as it is witnessing a shift towards nuclear family structures, where there is more financial burden on elderly individuals.
• If there are two senior citizens in a family, then the amount INR 5 Lakh coverage will be shared between them. 
• Those who are beneficiaries under other public health insurance schemes like Central Government Health Scheme (CGHS), ECHS, or Ayushman CAPF can either continue with their current schemes or opt for AB PM-JAY. 
• Apart from that senior citizens under private health insurance policies or the Employees’ State Insurance Scheme (ESIC) will be eligible to avail the benefits of AB PM-JAY. 

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UPSC Previous Year Questions

Year	Question
2017	In India, 'Universal Health Coverage' is viewed as a critical component of the healthcare system. Examine the significance of Universal Health Coverage in improving health outcomes in India. What are the challenges in implementing it?
2019	Critically analyze the role of Ayushman Bharat in improving healthcare delivery in India. Discuss the challenges faced in its implementation and suggest measures to address them.

UPSC Practice Questions

Q1. Discuss the impact of lifestyle diseases on public health in India. What measures should be taken to mitigate the rise of these diseases?

Q2. Evaluate the effectiveness of the National Health Mission (NHM) in improving healthcare delivery in rural areas. What are the major obstacles faced by the NHM?