How To Fix Ayushman Bharat: Experts To FM

'Patients under the scheme may ultimately have to go to private hospitals.'

Health and education sector experts on Thursday, June 27, 2024, urged Finance Minister Nirmala Sitharman to address issues of low reimbursement rates in the Ayushman Bharat scheme, focus on the availability of subsidised adult vaccinations, and help states in implementing the National Education Policy (NEP) in a pre-budget meeting.

While sources suggest that the government may expand the ambit of the Ayushman Bharat scheme to cover everyone over 70 years, experts at the meeting suggested the government to look into issues faced by hospitals due to the low reimbursement rates in the scheme.

One of the experts suggested that several high-end hospitals that run tertiary care services may not empanel themselves in the scheme as the present reimbursement rates are too low to cover the treatment costs borne by the hospital.

"Patients under the scheme may ultimately have to go to private hospitals as 85 per cent of tertiary care beds are in the private sector," he said.

"We have suggested the government to either increase Ayushman Bharat and Central Government Health Services (CGHS) rates to cover costs or opt for a co-payment scheme," an attendee said on the condition of anonymity.

During the pre-Budget meeting with the finance minister as well as top officials from the finance, health, and education ministries, experts called for measures to enhance and increase the scope of healthcare services at the grassroots level.

"There was discussion to introduce specific projects to tackle sickle cell anaemia in tribal population, along with ways to address congenital diseases such as congenital deafness and juvenile diabetes in children," Dr Anant Pandhare, vice chairman, Indian Red Cross Society and medical director, Hedgewar Hospital said.

"The government wanted to understand what more can be done to help the poor and we gave suggestions accordingly," Dr Pandhare added.

Health experts also proposed that awareness should be created about vaccines for adults, such as the influenza vaccine or cervical cancer vaccine, adding that they should be available at subsidised rates.

"Many people might not be knowing about the importance of influenza and cervical cancer vaccines. So there is a need to create awareness and provide these vaccines either free of cost or at subsidised rates," Giridhar Gyani, director general of the Association of Health Providers-India said after meeting the finance minister.

Experts from the education sector asked the government to help state and Union Territory administrations in understanding the NEP.

"We suggested that the government form a separate cell to assist states in NEP implementation," an expert who attended the meeting said.

Experts also highlighted the need to increase the availability of hospital beds across the country.

"We have presented the government data that currently there are two beds per thousand in the country while World Health Organisation standards require that number to be at least 3.5 beds per thousand," Gyani said.

"This has caused a bed disparity among states, which needs to be addressed by the government by investing more in beds in primary, secondary, and tertiary care," an expert added.

Feature Presentation: Rajesh Alva/Rediff.com