While the Centre is working hard to ensure the smooth roll out of the Modi Government’s flagship healthcare scheme, Ayushman Bharat-National Health Protection Mission (AB-NHPM), state elections could prove to be speed breakers.
By mid June, 24 states and union territories had signed MoUs to join up, in stark opposition to West Bengal which defied the Centre and opted out. Major states like Maharashtra, Odisha, Rajasthan which have elections in the next 12 months, are also resisting as they would like to project their health schemes as part of their poll promises. For instance, two days before the conclave of state and union territory health ministers met in Delhi in mid June, Naveen Patnaik, Chief Minister, Odisha launched the ‘Biju Swasthya Kalyan Yojana’, a health coverage scheme named after his father. The initiatives are slated to be implemented by August 15, a date reportedly being considered for the official launch of the AB-NHPM as well.
In other states with existing health schemes, the Centre has made it clear that they will partner with these schemes rather than absorb them into the AB-NHPM. Savvy state governments seem to have realised that if they play their cards right, they could have their cake and eat it too. Meaning that the existing health schemes can continue to operate in their names, and yet get AB-NHPM funding. How this uneasy alliance will actually play out is anyone’s guess.
Union Minister of Health and Family Welfare JP Nadda has emphasised that the success of the scheme hinges on the active participation of the states, who need to “own the scheme” while Centre will design the policy framework with all possible flexibility and support. Naddaji’s comment reveals a keen appreciation that every cog in the wheel needs to be working in tandem for the true success of AB-NHPM. This could be the single largest masterstroke (or blunder) of the present government. Its implementation could well win or lose the 2019 elections for the BJP and Prime Minister Narendra Modi.
Thus, concerns of all key stakeholders are being addressed. For instance, the Indian Medical Association (IMA), was a vehement critic of the scheme, pulling it up for ‘conceptual deficits and operational flaws’ related to pricing of treatment packages. But, once assured that NITI Aayog would be steering costing studies to guide the proposed continual adjustment of benefit packages and their rates, IMA’s main concerns were addressed. The association has now agreed to collaborate with the centre to create awareness about the scheme.
IMA’s support is crucial as healthcare professionals are the foot soldiers of the AB-NHPM, the ones who will actually be treating patients under the scheme. India already has an acute shortage of doctors and given that AB-NHPM involves liaising with the government for pre approvals and reimbursements, how many of them would agree to come on board? Larger hospitals have approached the authorities to revise the treatment package rates as they are unviable. But smaller healthcare facilities have shown more interest as they probably see the AB-NHPM as a way to increase their volumes. The scheme could turn out to be a saviour for many regional doctor/ promoter driven healthcare facilities and chains, who are finding it difficult to break even.
It is at this crucial crossroads that Express Healthcare is hosting the third edition of Healthcare Senate, from July 12-14 in the national capital. The agenda is packed with panel discussion and presentations on a range of topics. We start with corporate hospital CEOs debating the way forward on AB-NHPM, move on to access strategies in the era of price control, and continue to the need for core values and ethics, the battle for sustained innovation leadership and consolidation in healthcare. The three-day conclave will also host the third edition of the Express Healthcare Excellence Awards, the second edition of the Best Corporate Hospital Pharmacies Citations 2018 and the first ever Express Healthcare Medical Imaging Awards 2018. Catch all the action live on our social media feeds and detailed report in the August issue of Express Healthcare.
VIVEKA ROYCHOWDHURY, Editor