What lessons should the universal health coverage challenge of India take?

A woman in Mount Abu in Rajasthan’s southern district of Sirohi named Rambha Prajapati is suffering from severe kidney disease. Her condition demands regular dialysis that is a life-saving procedure without which Rambha would succumb to bodily toxins that her kidneys cannot eliminate. The community health center in Mount Abu does not come with dialysis facility that makes her visit the private hospital two times in a week where she has to present her Bhamashah Swasthya Bima Yojana card and her photo identification in order to undergo the dialysis procedure without any cost.

Overwhelmed Prajapati recollecting her bout of illness that had led to her kidney failure diagnosis was reported telling the reporters that when she fell very ill during the last of August, she was saved by this private hospital. Price-less treatment under the BSBY scheme that has been named after Bhama Shah who is a fabled general and minister in the erstwhile kingdom of Mewar has significantly won the Rajasthan government Prajapati’s gratitude for sparing her the current health expenses that would have left her family into extreme poverty.

Rambha is a widowed woman who lives with her son on the latter’s income of Rs. 9,000 a month from working in a small shop in the daytime and offering tuitions in the evening. Without the help of BSBY, Rambha’s story would have mirrored that of seven in every 10 Indians who seek outpatient and inpatient care from private hospitals when they fall sick because the government health infrastructure falls short. Without the health insurance, they would end up paying from their own means.

Serious or chronic diseases that entail high expenditure push them into deep poverty-health-related expenses accounted for nearly 7% of Indian households that fell below the poverty line between 2004 and 2014; this media paper based on national sample survey office figures said. More than 52.5 million Indians were improvised because of health costs in 2011 alone-almost half of the world’s population impoverished annually-FactChecker reported in December 2017. Recognising the imperative to protect India’s poor and vulnerable, the central government announced Ayushman Bharat, a programme that covers primary, secondary, and tertiary healthcare, in February 2018.

The programme targets to provide free essential drugs and diagnostic services for the illness that does not necessitate hospitalization through 150, 000 health & wellness centers and as an insurance cover of up to Rs. 5 lakh per year per beneficiary family for hospitalization, both secondary and tertiary care.

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