New Delhi: In the eight weeks the Ayushman Bharat insurance scheme has been in place, about 68% of the beneficiaries have reportedly been treated in private hospitals.
According to a Times of India report, of the 2.3 lakh beneficiaries who have been admitted to various hospitals in India under the scheme, 1.56 lakh patients have been treated in private ones.
Although the data covers just two months, it is useful as an early indicator of the direction the scheme is moving in. The private sector had for months been pressuring the government to increase remuneration to their facilities for patients treated under Ayushman Bharat. They had even threatened to not participate in the government’s insurance scheme.
The fact that nearly 70% of patients so far have been treated in the private sector shows that many hospitals have been amenable to participating in the scheme – at least for now.
Also read: Ayushman Bharat Trivialises India’s Quest for Universal Health Care
Times of India also reported that so far, the government has received 55,482 applications for hospital empanelment – 15,000 hospitals have either been empanelled or are under processing and around 8,000 empanelled hospitals are from the private sector.
As of September, government officials said 10,500 private hospitals had applied for empanelment.
Just presenting the facts. 20,000+ hospitals have applied including 10,500 private hospitals. Of these, nearly 13,000+ are approved or in-process for approval. @PMOIndia didn’t say 13,000 as private. Speech attached for reference https://t.co/uCKV90YhYm@ibhushan @AyushmanNHA
— Dr Dinesh Arora (@drdineshias) September 24, 2018
Health activists have, however, cautioned against this very aspect of high involvement of the private sector in health coverage. For example, they have raised concerns based on research and data on how the private sector often inflates medical procedure costs in order to claim more insurance paybacks.
More men avail the health insurance than women
The Ayushman Bharat health insurance scheme was announced in this year’s budget in February. It aims to cover 50 crore beneficiaries in India, with a health insurance coverage of Rs 5 lakh per family.
According to Times of India, most patients till now have been men – 58%. The states that have enrolled the most patients in the private sector are Gujarat, Tamil Nadu, Maharashtra and West Bengal.
The most popular medical procedures done have been oral and maxillofacial surgery, general surgery, ophthalmology and gynaecology.
Patients in the public and private sector are using this insurance
In August, the first baby under this scheme was born in a government hospital in Haryana. The delivery received wide press coverage, with the baby girl being called the “Ayushman Bharat baby.” The family was reimbursed Rs 9,000 for the caesarean section delivery.
In the last eight weeks, bureaucrats handling the insurance scheme have often tweeted about patients being treated – but in government hospitals, where treatment is anyway supposed to be free in India.
Also read: Before the Birth of First Child Under It, Many Rebirths of Government’s Health Insurance Scheme
22 year old male suffered crush injury. Led to massive bleeding of left leg by accidentally falling on railway track. Amputation procedure was done at District Hospital Siwan, Bihar under #AyushmanBharat to save his life. @AyushmanNHA wishes him full recovery @PMOIndia @ibhushan
— Dr Dinesh Arora (@drdineshias) October 4, 2018
40 yr male at Bokaro suffered cervical injury due to fall from roof. He had C7 vertebra severe cord compression & quadriplegia. The patient was promptly operated wt implant under #AyushmanBharat at RIMS Ranchi free of cost. Patient recovering well.@PMOIndia @ibhushan @amitabhk87 pic.twitter.com/PcELUFfoo1
— Dr Dinesh Arora (@drdineshias) October 6, 2018
If this trend continues, of patients being covered under this scheme being treated only in the public sector, then the scheme may not actually cater to the large demand for health services in the country.
It would essentially mean the government is paying itself for treating patients that should anyway be treated for free and at the same time claiming that something exceptional was occurring.