According to recently provided data from the National Health Authority (NHA), the treatments for non-covid procedures, offered by both private and government facilities across the country saw a significant decline of over 20% between February, 2020 and April, 2020.
Negative Impact of Covid-19 and Lockdown on AB-PMJAY
The global Covid-19 pandemic along with the ensuing lockdown have negatively impacted the ability of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana’s (AB-PMJAY) to cater to patients below poverty line. This adverse effect has been particularly noted in critical care treatments.
The Drop in Various Medical Treatments
There has been a marked decrease across several medical services under AB-PMJAY. The Cardiology procedures, for instance, experienced a decline by 45%. General Surgeries also dropped by 23%, while obstetrics and gynaecology related procedures fell by 25%. The only exception to this downward trend was found in ‘General Medicine’, which showed a slight increase.
Affect of Lockdown on Private Care Hospitals
Private care hospitals, where treatments under AB-PMJAY can be accessed, were largely closed during the lockdown period. Additionally, the government itself encouraged individuals with non-critical illness to seek medical help via telemedicine or to prioritize only essential treatments such as dialysis or non-elective surgeries.
Fears of Infection Lead to Decreased Hospital Visits
With reports of Covid-19 infections among healthcare workers and doctors in both private and public hospitals, there was a noticeable reduction in general hospital visits.
An Overview of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
The AB-PMJAY scheme offers an insured sum of Rs.5 lakh per family for secondary care (which doesn’t involve a super specialist) as well as tertiary care (which involves a super specialist). This entitlement-based scheme targets beneficiaries identified by the latest Socio-Economic Caste Census (SECC) data and allows the insured to access any empanelled hospital. The cost of insurance is divided mostly in a ratio of 60:40 between the centre and the state.
Understanding Packaged Rates and Medical Management
The AB-PMJAY scheme includes ‘packaged rates’, which include everything without charging for each individual product or service. Although these rates are flexible, once set by the hospitals, they can’t charge the beneficiary. Along with packaged rates, the scheme has a prescribed daily limit for medical management.
National Health Authority (NHA) and State Health Agency (SHA) – An Integral Part of AB PM-JAY
The NHA, constituted as an autonomous entity under Society Registration Act, 1860, collaborates with state governments for the effective implementation of PM-JAY. On the state level, the State Health Agency (SHA) stands as the apex body responsible for executing AB PM-JAY.
