Background

India with 1.34 billion population is facing unique health care delivery problems particularly regarding the poor spending on health, access, quality, safety, lack of accountability, corruption, etc. Inequalities and health–related expenses resulting in impoverishment further marginalises the poor, underprivileged and outreach. The government of India has come up with a highly ambitious initiative Ayushman Bharat – National Health Protection Mission (AB–NHPM) as a shift from traditional health planning approaches towards a comprehensive healthcare vision.

Methods

Literature available, government publications, documents, press releases and other related material has been consulted to appraise the NHPM initiative.

Results

AB–NHPS was officially announced by Prime Minister Narendra Modi on 15 August 2018, in his Independence Day speech. This flagship project will be launched on September 25, 2018. The objective of ambitious AB–NHPSis to provide coverage of INR 500,00 per family annually, benefiting more than 10 crore poor families. The scheme will target poor, deprived rural families and identified occupational category of urban workers’ families, 8.03 crore in rural and 2.33 crore in urban areas, as per the latest Socio–economic Caste Census (SECC) data. The eligibility criteria include: 10 crore families belonging to poor and vulnerable population based on SECC database, will take care of almost all secondary care and most of tertiary care procedures, the entitlement will be decided on the basis of deprivation criteria in the SECC database, automatically included families in rural areas having any one of the following: households without shelter, destitute, living on alms, manual scavenger families, primitive tribal groups, legally released bonded labour, will also come under this scheme. For urban areas, 11 defined occupational categories will be entitled under the scheme, the treatment in case of hospitalization will be free of cost for the family, all pre–existing conditions will be covered from day one of the policy. The benefit cover will include pre and post hospitalization and the beneficiary will be able to go to public or empanelled private hospitals across the country and get free treatment.

Conclusion

The NHPS enjoys a guaranteed potential to improve the lives of millions of Indians. The scheme is prominent against the backdrop that several Central Ministries and State/UT Governments have launched health insurance/ protection schemes for their own specific set of beneficiaries. To improve their efficiency, reach and coverage, a critical need has been recognized to converge these schemes, such as the Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

This article presents the critical analysis of policy initiative, philosophy, key features, implications, impact, concerns, constraints and paving the way for future healthcare solutions