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West Bengal Leaves Ayushman Bharat : In-depth Analysis

West Bengal Leaves Ayushman Bharat : In-depth Analysis

Relevance

  • GS 2 || Governance || Human Development || Health

 Why in News?

  • West Bengal recently announced to withdraw from Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY).

 Reasons Given by W. Bengal

  • Customized Letter: Beneficiaries of the Centre’s Ayushman Bharat insurance program have been sent a two-page customised letter from the prime minister outlining the importance and benefits of the project.
  • The government also planned to send similar letters to 10.74 crore beneficiary families across the country.
  • The letter states that the beneficiary family can avail the scheme in hospitals in their area and health facilities empanelled under the scheme across the country.
  • Over-Branding: Since the letter sent to beneficiaries has photos of Prime Minister, West Bengal state argued that as over branding.
  • Name of the Scheme: The West Bengal government feels that given the 60:40 partnership in the scheme, the state government should get similar space on documents.
  • Also there is a problem with name of the scheme itself, wherein the West Bengal government chose to call the scheme Jan Arogya Yojana rather than Pradhan Mantri Jan Arogya Yojana.
  • Swasthyasathi: Since West Bengal already had a well-established scheme Swasthyasathi, the state government would like to retain the name Swasthyasathi in the scheme.
  • Confusion at the Grassroot Level: The state argues that it may create confusion at the grassroots level.

 Consequences

  • Swasthyasathi Scheme:West Bengal’s Swasthyasathi scheme was launched in 2016 to provide basic health cover for secondary and tertiary healthcare up to Rs 5 lakh per annum per family, same as PMJAY.
  • Till now, around 1 crore people have been enrolled under the central scheme in West Bengal, while the state scheme already had 40 lakh beneficiaries.
  • National Portability: For PMJAY, the pullout is a setback because it affects the national portability of the scheme.
  • Kolkata is regarded as a considerable city from the Northeast and from states such as Bihar for healthcare. So, officials fear it could impact more people than just the beneficiaries in West Bengal.

 Three More States

  • Delhi, Telangana and Odisha have also withdrawal from the PMJAY.
  • Reasons by Odisha of the withdrawal:
    • Odisha launched Biju Swasthya Kalyan Yojana (BSKY), about 40 days before the launch of PMJAY in September 2018. BSKY will give an insurance cover up to Rs 5 lakh per eligible family and Rs 7 lakh for treatment of female members.
    • Another schemes Niramaya (free medicines), Nidan (free diagnostics), and Sahay (dialysis and chemotherapy in all districts) to every beneficiary family.
    • Delhi, like West Bengal, has an issue with the name of the central scheme and has also raised this with the implementing agency – National Health Agency.
  • Reasons by Delhi of the withdrawal:
    • Delhi wanted the name of the scheme as Mukhya Mantri Aam Aadmi Swasthya Bima Yojana Ayushman Bharat for implementation in the union territory and requested the NHA.
    • The NHA said that, since this is a national scheme with national character, which is reflected in AYUSHMAN BHARAT.
    • It also added that this will also help in operationalizing portability and easy demarcation of beneficiaries.
  • Reasons by Telangana of the withdrawal:
    • Telangana professes one of the oldest functioning tertiary care health schemes by The Arogyashri scheme, providing financial protection to families living below the poverty line up to Rs 2 lakh in a year.
    • Around 949 treatments are covered, including treatment of serious ailments that requires hospitalization and surgery.
    • By 2017-18 data, there are 77.19 lakh beneficiary cards with 330 empanelled

 Center’s Submission

  • Ayushman Bharat family letter is neither a beneficiary card nor an entitlement card.
  • Only one of the modes of spreading awareness within beneficiaries.
  • Essential part of beneficiary identification guidelines, given that Ayushman Bharat is an entitlement based scheme.
  • Center has requested West Bengal Govt. to rethink on its stance.