In this piece for the Deccan Herald, Shuchin Bajaj, our 2022 New Voices Fellow, and Nachiket Mor examine the strengths and weaknesses of the Pradhan Mantri Jan Arogya Yojana (PMJAY). PMJAY is the world’s largest health assurance program. It aims at providing health coverage of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to marginalized and vulnerable families. Launched in 2018, over the past five years, PMJAY has issued over 27 crore insurance cards and financed over 5.75 crore hospital admissions. Out of the 27,000 hospitals nationwide that are part of the program, 15,000 are in the public sector.
One of the many significant findings noted by Bajaj and Mor is that while PMJAY has not yet moved towards total health system financing in any part of the country, given its finding limitations, its move towards paying hospitals on a package basis and not on a procedure-by-procedure basis has shown beneficial impacts such as better infection control at hospitals resulting in patients getting discharged quicker.
Bajaj and Mor also offer several recommendations to further strengthen and fill gaps in the existing program. One of these is the “need to build and staff more public sector hospitals… and where appropriate, devise incentives for the private sector to set up facilities…” in remote regions as a way of addressing the high percentage of inactive hospitals, over 25% , under the program. They also emphasize the next “big move” in India’s healthcare sector is the complete transfer of state health budgets to their State Health Authorities.
To read more about the PMJAY and Bajaj and Mor’s analysis click below.