Why in the news?

  • Ayushman Bharat marks 7 years of launch.

Ayushman Bharat

  • Launch: 2018
  • Associated Policy: Flagship scheme under National Health Policy, 2017.
  • Aim: Achieve Universal Health Coverage (UHC) by providing financial protection and strengthening primary healthcare.
  • Components:
    • Health and Wellness Centres (HWCs)
      • Target: 1.5 lakh centres by transforming existing Sub-Centres & Primary Health Centres.
      • Services provided:
        • Maternal & child health,
        • Non-communicable diseases,
        • Free essential drugs & diagnostics,
        • Mental health, palliative care, elderly care.
      • Community participation & use of ASHA workers and telemedicine.
    • Pradhan Mantri Jan Arogya Yojana (PM-JAY)
      • World’s largest government-funded health insurance scheme.
      • Provides health cover of ₹5 lakh per family per year for secondary & tertiary care hospitalization.
      • Beneficiaries:
        • ~10.74 crore poor and vulnerable families (≈50 crore individuals).
        • Identified through SECC (Socio-Economic Caste Census) 2011 data.
      • Cashless & paperless access through Ayushman Bharat Health Card.
      • Covers 1,500+ procedures including surgeries, medicines, diagnostics, pre/post hospitalization.
  • Implementation: National Health Authority (NHA).
  • Achievements:
    • 5 crore+ hospital admissions authorized under PM-JAY.
    • Over 2 crore Ayushman Bharat Health Accounts (ABHA IDs) created under ABDM.
    • 1.65 lakh+ HWCs operational across India.
    • Estimated savings of ₹30,000 crore for poor families.
  • Significance:
    • Provides financial risk protection for poor households against catastrophic health expenditure.
    • Strengthens primary, secondary & tertiary healthcare.
    • Reduces out-of-pocket expenditure (OOPE) – a major cause of poverty in India.
    • Promotes cooperative federalism – Centre & States share costs.
    • Encourages private hospitals participation in social welfare.
  • Challenges:
    • Coverage gaps: Many vulnerable groups outside SECC 2011 data not covered.
    • Awareness deficit: Beneficiaries often unaware of entitlements.
    • Healthcare infrastructure deficit: Shortage of doctors, nurses, hospitals in rural areas.
    • Private sector reluctance: Many empanelled hospitals not participating actively due to low package rates.
    • Fraud & misuse: Fake hospital admissions, misuse of insurance claims.