New Delhi: In less than two weeks, the Indian Medical Association has gone from saying the government’s new health insurance scheme was “highly optic” to saying that it was “proud to be associated” with it.
.@IMAIndiaOrg fully backs Ayushman Bharat. Joined hands with National Health Agency for helping in empanelment of hospitals, beneficiary identification and spreading awareness about #AyushmanBharat National #Health Protection Mission. #ABNHPM #SwasthyaAapkaSaathHamara pic.twitter.com/0Vi2JgD0RT
— National Health Agency (NHA) (@AyushmanNHA) June 22, 2018
This change of heart was announced after a meeting between Indu Bhushan, the CEO of Ayushman Bharat-National Health Protection Mission (AB-NHPM) and Dr R.N. Tandon, secretary general of Indian Medical Association (IMA).
“IMA representatives agreed to extend their support for better implementation of AB-NHPM especially in field of empanelment of hospitals, spreading awareness and beneficiary identification processes,” said a press note by the health ministry. The government’s press release said that IMA “fully backs” the scheme.
Dr Tandon said, “IMA is proud to be associated with AB-NHPM.”
Bhushan said, “IMA is a critical stakeholder in AB-NHPM as private sector role is key.”
The government announced the AB-NHPM in February, promising a health insurance cover of Rs 5 lakh per family for about ten crore families.
Strong opposition to the scheme till two weeks ago
Less than two weeks ago, IMA had strong and reasoned criticisms of the insurance scheme. Apart from dismissing the scheme as one that was “highly optic,” they said that it failed to create “any new national asset”.
“The same money invested in our public hospitals would have brought secondary and tertiary care closer to the poor in our government hospitals.”
The highly optic National Health Protection Scheme (NHPS) fails to create any new national asset, says, Ravi Wankhedkar, National President, Indian Medical Association.@docraviw #NHPS #mediawatch #doctors #Healthcare #transparency pic.twitter.com/honE0VQjGI
— Indian Medical Association (@IMAIndiaOrg) June 18, 2018
They suggested that this money allocated for AB-NHPM could be used better if every district hospital was instead strengthened with infrastructure worth Rs 2 crore. They called this their “firm opinion.”
They also derided the insurance mode of healthcare entirely on ethical as well as economic grounds. They said that Rs 400 crore would be lost to private insurance companies, that “insurance driven healthcare is a failed experiment” and that the “current policy change in India will only end up strengthening the insurance business.”
They also said that intermediaries such as insurance companies and administrators would syphon off 40% of the budget as they are “breeders of corruption and unethical practices.”
Thirdly, they had opposed the scheme due to what they consider to be low rates of reimbursement offered by the government. They said the rates were “abysmal and impracticable” and that the scheme would thus be a “non-starter.” IMA’s assessment concluded that the reimbursements offered by the government don’t cover even 30% of the cost of procedures and that this would subsequently compromise patient safety.
They ended their strong statement by demanding a review of the concept and operational aspects of the scheme.
None of IMA’s demands appear to have been met
While none of their three main grievances seem to have been addressed, nor has an entire review of the scheme been agreed upon by the government, IMA has taken the U-turn and agreed to partner with the government on it.
They had raised other issues with the NITI Aayog and Union health ministry such as the reimbursement rates, timely payments to hospitals, grievance mechanisms, IT infrastructure and the need for NABH accreditations for hospitals.
Other private hospital networks are also dropping their opposition
Powerful private hospital networks all over the country are starting to back down on their opposition to the scheme.
#NewsFromNITI: Team NITI & @AyushmanNHA meet private providers to pave the way forward for the successful implementation of #AyushmanBharat across rural & urban India! pic.twitter.com/NbMQB3Li29
— NITI Aayog (@NITIAayog) June 22, 2018
Much like the IMA, they too had written to the government calling the reimbursement rates “unscientific.”
However, as The Wire reported this month, the government has totally refused to review the rates of reimbursement being offered, overriding concerns expressed by several powerful hospital groups lobbying for increases.