TNPSC Thervupettagam

Ayushman Bharat–PM Jan Arogya Yojana

January 25 , 2019 2148 days 5078 0
History
  • The Government of India is currently focusing largely on Reproductive, Maternal, New-born, Child and Adolescent Health (RMNCH+A) and communicable diseases.
  • Families are forced to incur high out of pocket expenditure thereby leading to impoverishment and poverty.
  • Health is an important cornerstone to the Government’s vision of development, ‘Swasth Bharat, Samriddha Bharat’ (Healthy India, Prosperous India).
  • To fulfil the vision of Health for All and Universal Health Coverage, enshrined in the National Health Policy 2017, the Government conceived Áyushman Bharat’ (Healthy India), a pioneering initiative led by the Prime Minister.
Formation
  • Ayushman Bharat Yojana or Pradhan Mantri Jan Arogya Yojana (PMJAY) or National Health Protection Scheme is a centrally sponsored scheme launched in 2018, under the Ayushman Bharat Mission of Ministry of Health and Family Welfare (MoHFW) for a New India -2022.
  • Ayushman Bharat (AB) is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service.

  • The scheme aims at making interventions in primary, secondary and tertiary care systems, covering both preventive and pro-motive health, to address healthcare holistically.
  • It is an umbrella of two major health initiatives namely, Health and Wellness centres and National Health Protection Scheme (NHPS).
  • The scheme is formed by subsuming multiple schemes including Rashtriya Swasthya Bima Yojana, Senior citizen health Insurance Scheme (SCHIS), etc.
  • Further, the National Health Policy, 2017 has envisioned Health and Wellness Centres as the foundation of India’s health system which the scheme aims to establish.
Features
  • The PM-JAY is one significant step towards achievement of Universal Health Coverage (UHC) and Sustainable Development Goal - 3 (SDG - 3).
  • For focused approach and effective implementation of PM-JAY, an autonomous entity, the National Health Agency (NHA) was constituted.
  • Established as a Society on 11th May 2018, the National Health Agency is registered under the Society Registration Act, 1860.

  • The State Governments are similarly expected to set up State Health Agencies (SHA) to implement PM-JAY.
  • The National Health Agency (NHA) will provide overall vision for design, implementation and management of Pradhan Mantri Jan Arogya Yojana (PM-JAY).
Health and Wellness Centres
  • Under this 1.5 lakh existing sub centres will bring health care system closer to the homes of people in the form of Health and wellness centres.
  • These centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services.
List of Services to be provided at Health & Wellness Centre
  • Pregnancy care and maternal health services
  • Neonatal and infant health services
  • Child health
  • Chronic communicable diseases
  • Non-communicable diseases
  • Management of mental illness
  • Dental care
  • Eye care
  • Geriatric care Emergency medicine
National Health Protection Mission (AB-PMJAY)
Eligibility criteria
  • The different eligibility categories in rural and urban areas are
    • families having only one room with kucha walls and kucha roof;
    • families having no adult member between age 16 to 59;
    • female headed households with no adult male member between age 16 to 59;
    • disabled member;
    • SC/ST households;
    • landless households deriving their income from manual casual labour,
    • Families in rural areas having any one of the following: households without shelter, destitute, living on alms, manual scavenger families, primitive tribal groups, released bonded labour.
    • In urban areas, 11 defined occupational categories are entitled under the scheme.
      • Rag picker.
      • Domestic worker.
      • Street vendor/ Cobbler/hawker / Other service provider working on streets.
      • Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and head-load worker.
      • Sweeper/ Sanitation worker.
      • Home-based worker/ Artisan/ Tailor.
      • Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller.
      • Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery assistant / Attendant/ Waiter.
      • Electrician/ Mechanic/ Repair worker.
      • Washer-man/ Chowkidar.
As per the SECC 2011, the following beneficiaries are automatically excluded:
  • Households having motorized 2/3/4 wheeler/fishing boat.
  • Households having mechanized 3/4-wheeler agricultural equipment.
  • Households having Kisan Credit Card with credit limit above Rs. 50,000/.
  • Household member is a government employee.
  • Households with non - agricultural enterprises registered with government.
  • Any member of household earning more than Rs. 10,000/ - per month.
  • Households paying income tax.
  • Households paying professional tax.
  • House with three or more rooms with pucca walls and roof.
  • Owns a refrigerator.
  • Owns a landline phone.
  • Owns more than 2.5 acres of irrigated land with 1 irrigation equipment.
  • Owns 5 acres or more of irrigated land.
  • Owning at least 7.5 acres of land or more with atleast one irrigation equipment.
Benefits of PM-JAY
Benefits
  • AB-PMJAY provides a defined benefit cover of Rs. 5 lakh per family per year.

  • To ensure that nobody is left out (especially women, children and elderly).
  • There will be no cap on family size and age in the scheme.
Beneficiary Level
  • More than 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries) covered across the country.
  • All families listed in the SECC database as per defined criteria will be covered.

  • Priority to girl child, women and senior citizens.
  • Free treatment available at all public and empanelled private hospitals in times of need.
  • Covers secondary and tertiary care hospitalization.
  • 1,350 medical packages covering surgery, medical and day care treatments, cost of medicines and diagnostics.
  • All pre-existing diseases covered.
  • Hospitals cannot deny treatment.
  • Hospitals will not be allowed to charge any additional money from beneficiaries for the treatment.
  • Eligible beneficiaries can avail services across India.
  • Can reach out for information, assistance, complaints and grievances to a 24X7 helpline number – 14555.
 Health System
  • Help India to achieve Universal Health Coverage (UHC) and Sustainable Development Goals (SDG).
  • Significantly reduce out of pocket expenditure for hospitalization.
  • Strengthen public health care systems through infusion of insurance revenues.
  • Enable creation of new health infrastructure in rural, remote and under-served areas.
  • Increase health expenditure by Government as a percentage of GDP.
  • Enhanced patient satisfaction.
  • Improved health outcomes.
  • Improvement in population-level productivity and efficiency.
  • Improved quality of life.

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