Modicare : A Game Changer
------------------------------------
In his budget speech yesterday, Shri Jaitley announced
launching of ,
Ayushman Bharat [ National Health Protection Scheme ]
It will be a game changer
----------------------------------------------------------------------------------------
HIGHLIGHTS :
·
It
will cover 10 crore poor families ( approx. 50 crore persons ; 40 % of our
population )
·
It
will pay insurance premium for coverage of Rs 5 lakh claims per family per year
·
At
Rs 5,000 premium ( for Rs 5 lakh ) , total cost to government could be Rs
50,000 cr / year.
Some other
estimates place the annual outgo on premium of between Rs 2 – 2.5 lakh*crore
·
Because
of the huge size of the scheme, government will be able to negotiate the cost
of the medicines and the services
·
Budget
allocation = Rs 2,000 crore
·
It
will subsume earlier scheme “ Rashtriya Swasthya Bima Yojana “ of Rs
30,000 / year claim
·
It
will be the biggest such Health Insurance Scheme, anywhere in the World
·
Details
of the mechanism of the scheme are yet to be worked out and announced
·
Budget
also allocated Rs 1,200 crore to create “ Health and Wellness Centres “ in
India’s 1.5 lakh “ Health Sub Centres “ , to provide free essential medicines
closer to home through primary , secondary and tertiary health systems
·
Budget
also allocated Rs 600 crore for nutritional support at Rs 500 per month to TB
patients ( which infects an estimated 27.9 lakh people each year and kills 4.23
lakh persons )
----------------------------------------------------------------------------------------------
COMMENTS :
·
Opposition
parties say : This is a “ Jumla “ and will flop like the earlier scheme
·
Experts
say : We just don’t have any experience in running such a massive scheme
·
Economists
say : Where is the money ?
·
Pratap
Reddy ( Apollo Hospital ) says : This will be a game changer
·
R
Sabesan ( Dr Agarwal group of Eye Hospital ) says : It will allow mid-sized
healthcare players to invest and thereby improve the quality of healthcare in
the country
·
Shailaja
Chandra ( Former Secretary at the Health Ministry ) says : Insurance companies
could end up reaping the benefits of the health coverage scheme . There is a
need for a regulatory mechanism to make sure they pay patient bills without
delay
·
Indranil
Mukhopadhyay ( Asst Prof , Jindal University ) says : The allocation the
government would need to pay for just the premiums is about Rs 1.2 lakh*crore
and the country’s total spending on health is about Rs 1.3 lakh* crore. There
is no clarity on how this will be rolled out and who will foot the bill - a
plan that mirrors the confusion of the 2016 proposal . There has been barely
any follow up action on the past UHC announcements
·
Antony
Jacob ( Apollo Munich Health Insurance ) says : The medical services sector is
optimistic about the scheme leading to large-scale employment opportunities .
It will help create several lakh new jobs as new healthcare facilities will
come up in smaller districts and villages
Sad Thing :
·
No
one has come up with a concrete proposal which says : Here is how we can make it work
MY SUGGESTIONS :
·
The
scheme must cover
#
Supply of Medicines / Medical Devices ( both , preventive and curative )
# Delivery of Services ( Diagnostic / Nursing
/ Hospitalization )
# Pregnancy / Delivery related medicines / investigations /
hospitalization
Prices for each / all of these must be fixed and published , not only on the
web
site of the Health Ministry but at ALL places where medicines or services are
getting delivered
·
Each
eligible family member to be issued a “ Ayushman Card “ ( linked to Aadhar ID )
·
Ayushman
card will have inbuilt memory capacity to store that person’s health data from
“ Cradle to Grave “ ( Privacy advocate need not worry ! )
All the
Health Data of all 50 crore beneficiaries to be stored on a Central Server for
BIG DATA analysis , in order to “ Predict “ WHO might become susceptible to
WHICH ailment and WHEN
As an
alternative , a GPS enabled / NFC capable Smart Phone pre-loaded with AYUSHMAN
MOBILE APP , could be considered to replace the card
·
Ayushman
Eco System shall consist of :
#
50 crore poor beneficiaries
#
All Medical Practitioners of India (
Allopathic - Ayurvedic – Homeopathic )
# All Medical Shops of
India ( including E – Pharmacies )
# All Nursing Homes /
Hospitals / Diagnostic Centres / Health Centres etc
# All Pharma Companies
# Health
Ministry
#
All India
Medical Association
#
All
India Organization of Chemists and Druggists ( AIOCD )
# Drug Controller General of India
# All Medical Colleges /
Medical Research Centres
# Any other entity which I might have
missed out
The Ayushman Eco System shall be built around the BLOCK-CHAIN technology , which will be the
main operating system for implementation of the AYUSHMAN PROCESSES , described
in my following earlier blogs ( sent as emails to Cabinet Ministers / Niti
Aayog )
As to the relevance of BLOCKCHAIN technology to a
Healthcare Eco-System , read :
Consulting firm Deloitte
believes that "blockchain
technology has the potential to transform healthcare, placing the patient at the center
of the healthcare ecosystem and increasing the security, privacy, and
interoperability of health data."
Medicalchain, on the other hand, uses blockchain technology to store and share health records securely, allowing for easy and safe transfer of information between providers and patients.
The
Bounty of Big Data [ 30
April 2016 ]
No comments:
Post a Comment