Skip to main content

Ayushman for 70+: Good scheme despite glitches; but will private hospitals fleece govt coffers?

I was quite excited when Prime Minister Narendra Modi launched what was called "the expanded Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme" for those  aged 70 and above, irrespective of their socio-economic status, with a benefit cover of Rs 5 lakh per year in empanelled hospitals across India. 
Reportedly, the likely to benefit of the scheme are over 60 million senior citizens; it is part of the health projects worth Rs 12,850 crore launched by Modi about two weeks ago. However, the beneficiary base of the expansion is said to have been done with an outlay of Rs 3,437 crore. 
I decided to enrol myself as a beneficiary since I also found myself to be eligible -- instead of visiting the local government office, I decided to do it sitting at home in Ahmedabad online, which I found from the internet was very much possible.
So I first downloaded the Ayushman app, and tried doing it there. I found it to be an extremely slow app, refusing to go forward easily. Not without reason, its rating is 3.6/5. Disappointed users comment, not only OTP verification at every step is "very disturbing", there is no back button, drop arrows are not opening, has "many glitches", skips the screen "too often", and "nobody bothers that such apps are for the needy ones."
Hence, while I decided to go to do it on the online portal, I opened the app on November 14 and the message now reads: "Recent data from similar devices show that this app may stop working on your device". 
Strange, to say the least: Am using Samsung Galaxy A04e which has an Android version 14. If it can't be used on this, device which I bought a year ago, does the Government of India want 70 plus citizens, who have no regular income, to buy a more costly phone which is compatible with the app?
Be that as it may, after several tries online, which included getting OPT verified at least five times -- for mobile as well as for the aadhaar -- I succeeded in registering. It took me three hours to struggle through it, so complicated is the Aaushman portal. But finally I happily downloaded the card.
This prompted me to ask some other senior citizens to do it online instead of visiting the designated government office. A neighbour reached up to me with his 82 year old mother to help do it. So we got down to it. I registered her ditto as I did it for myself, and the final message said, "You can download the Aaushman card after some time."
Once you are registered, you must receive a message on mobile, but lo! No such message came. Even after aadhaar verification -- it took this grand old lady's each detail, including full name, age, even the aadhaar photo -- the message that she received said: You must upload your aadhaar card to the aadhaar portal  https://uidai.gov.in/." 
So there was no download. The neighbour decided to register the aadhaar on the Government of India's two apps -- Digilocker and Aadhaar app. He did this, we did the KYC again on the Aaushman portal, yet we were stuck: though the message in the end declared "Congratulations you can download the Aaushman card after some time", we couldn't go to the download link; instead there was a message on the portal stating Aadhaar couldn't be verified!
The grand old lady was taken to the government office next day morning in order to get the Ayushman card issued, as the online wasn't happening. On coming back, the dejected neighbour told me that the operator "tried out through different means for 15 minutes", but the Aadhaar was not getting verified! "Now I have been told to take her to a government health office to get the Aadhaar verified, only then Ayushman card would be made. This despite the fact that the Aadhaar had already been verified in Digilocker and Aadhaar apps, both Government of India's apps.
There is yet another confusion: the government office which does manual registration says in an unsigned chit pasted outside that Ayushman's total benefit would be up to Rs 10 lakh, though the portal said Rs 5 lakh. Let me clarify: Rs 10 is true for only those senior citizens who had registered themselves under the earlier Aayushman scheme which required an income and a lower age cap. As for other 70 plus citizens, it's Rs 5 lakh only.
Meanwhile, there is a huge flutter in Ahmedabad: two patients from Kadi town, about 20 km from Ahmedabad, died in a private hospital registered for Ayushman purpose after angioplasty was allegedly conducted without their consent. Both were the beneficiaries of the Aayushman scheme.
The entire incident reportedly came to light after the hospital organised a ‘free camp’ under PMJAY, even though "no such camps are allowed under PMJAY." An investigation has revealed that the hospital organised the camp without permission. The hospital's owner, CEO and the doctors who conducted the angioplasty "have gone underground."
According to the report, the hospital claimed about Rs 27.71 crore from the government for over 600 cardiology treatments. A total of 380 angiographies, 220 angioplasties and 36 coronary artery bypass grafting (CABG) surgeries were performed mostly under the earlier Ayushman scheme Between June 1 and 12; the hospital claimed funds for 650 cases from the Health Department.
The report further suspected political connection, stating, there were images on the social media of the hospital owner with the Gujarat health minister together. The owner in one image showed receiving an award from the minister in the presence of BJP bigwigs.
Searching for any criticism of the scheme, I found The Hindu daily saying in an editorial that while the move is welcome, especially considering that out-of-pocket expenditure for health care in India is "among the highest in the world." But there is a caveat: "it will in no way fulfil the public health objectives that are much needed for the targeted beneficiaries."
The editorial says, the scheme "is limited to secondary and tertiary care hospitalisation. The absence of coverage for outpatient care, diagnostics and medicines is particularly concerning as chronic diseases have increased sharply in India in the last few decades" with people over 70 very often suffering from these. 
It continues, "Most of the health-care expenditure by the elderly will, therefore, be through outpatient care (40%-80%), which will not be covered by the scheme. Since its launch in 2018, the penetration of PMJAY into smaller cities and towns has been low in most States. Unlike in most of the southern States, primary and secondary health care in the public sector has been largely neglected..."
The editorial concludes, "Weakened primary and secondary health care will result in an overload in tertiary health care, which the private players will be well poised to take advantage of. This can lead to a further shrinking of the government’s commitment to strengthen the public health-care system by over-relying on the insurance modality..."

Comments

TRENDING

Dalit rights and political tensions: Why is Mevani at odds with Congress leadership?

While I have known Jignesh Mevani, one of the dozen-odd Congress MLAs from Gujarat, ever since my Gandhinagar days—when he was a young activist aligned with well-known human rights lawyer Mukul Sinha’s organisation, Jan Sangharsh Manch—he became famous following the July 2016 Una Dalit atrocity, in which seven members of a family were brutally assaulted by self-proclaimed cow vigilantes while skinning a dead cow, a traditional occupation among Dalits.  

Powering pollution, heating homes: Why are Delhi residents opposing incineration-based waste management

While going through the 50-odd-page report Burning Waste, Warming Cities? Waste-to-Energy (WTE) Incineration and Urban Heat in Delhi , authored by Chythenyen Devika Kulasekaran of the well-known advocacy group Centre for Financial Accountability, I came across a reference to Sukhdev Vihar — a place where I lived for almost a decade before moving to Moscow in 1986 as the foreign correspondent of the daily Patriot and weekly Link .

Boeing 787 under scrutiny again after Ahmedabad crash: Whistleblower warnings resurface

A heart-wrenching tragedy has taken place in Ahmedabad. As widely reported, a Boeing 787 Dreamliner plane crashed shortly after taking off from the city’s airport, currently operated by India’s top tycoon, Gautam Adani. The aircraft was carrying 230 passengers and 12 crew members.  As expected, the crash has led to an outpouring of grief across the country. At the same time, there have been demands for the resignation of Prime Minister Narendra Modi, Home Minister Amit Shah, and the Civil Aviation Minister.

Global NGO slams India for media clampdown during conflict, downplays Pakistan

A global civil rights group, Civicus has taken strong exception to how critical commentaries during the “recent conflict” with Pakistan were censored in India, with journalists getting “targeted”. I have no quarrel with the Civicus view, as the facts mentioned in it are all true.

Whither SCOPE? Twelve years on, Gujarat’s official English remains frozen in time

While writing my previous blog on how and why Narendra Modi went out of his way to promote English when he was Gujarat chief minister — despite opposition from people in the Sangh Parivar — I came across an interesting write-up by Aakar Patel, a well-known name among journalists and civil society circles.

Remembering Vijay Rupani: A quiet BJP leader who listened beyond party lines

Late evening on June 12, a senior sociologist of Indian origin, who lives in Vienna, asked me a pointed question: Of the 241 persons who died as a result of the devastating plane crash in Ahmedabad the other day, did I know anyone? I had no hesitation in telling her: former Gujarat chief minister Vijay Rupani, whom I described to her as "one of the more sensible persons in the BJP leadership."

Why India’s renewable energy sector struggles under 2,735 compliance hurdles

Recently, during a conversation with an industry representative, I was told how easy it is to set up a startup in Singapore compared to India. This gentleman, who had recently visited Singapore, explained that one of the key reasons Indians living in the Southeast Asian nation prefer establishing startups there is because the government is “extremely supportive” when it comes to obtaining clearances. “They don’t want to shift operations to India due to the large number of bureaucratic hurdles,” he remarked.

Guha plans book to counter Dalit, Marxist, and right-wing critics of Gandhi, recalls Modi’s 'pernicious lie' on Patel

Let me first confess: writing about an event three weeks after it has taken place is no good, especially for a newsperson. However, ever since I attended the public lecture by well-known historian Ramachandra Guha on May 18, organised by Sarthak Prakashan for the release of the Gujarati edition of his book monumental book "India After Gandhi", frankly, I kept wondering if he had said anything newsworthy apart from what had already appeared in the media ever since the book's first edition came out in 2007. Call it my inertia or whatever.

A conman, a demolition man: How 'prominent' scribes are defending Pritish Nandy

How to defend Pritish Nandy? That’s the big question some of his so-called fans seem to ponder, especially amidst sharp criticism of his alleged insensitivity during his journalistic career. One such incident involved the theft and publication of the birth certificate of Masaba Gupta, daughter of actor Neena Gupta, in the Illustrated Weekly of India, which Nandy was editing at the time. He reportedly did this to uncover the identity of Masaba’s father.