New Delhi, India
Ahead of the Delhi Assembly elections in February next year, Aam Aadmi Party (AAP) leader Arvind Kejriwal announced on Wednesday (Dec 18) that all people above 60 years of age will receive free treatment at all government and private hospitals as a part of ‘Sanjeevani Yojana’ if AAP retains power in the national capital. 
The former chief minister said that the registration process for the scheme will begin in the next two to three days during an event at the party headquarters. He also said that people don’t have to go anywhere to get registered for the scheme, as AAP workers will go door to door to register eligible people.
Also read | <a href="https://www.wionews.com/india-news/india-farmers-protest-rail-roko-agitation-in-punjab-travellers-may-face-inconvenience-784880">India farmers' protest: 'Rail roko' agitation in Punjab, travellers may face inconvenience</a>
Kejriwal also said that there will be no upper limit on the cost of the treatment for the elderly registered under this scheme. The scheme will be implemented by the AAP government after the elections.
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दिल्ली के बुजुर्गों आप चिंता मत करना, आपका बेटा केजरीवाल अभी जिंदा है?
? 60 साल और उससे ज़्यादा उम्र के बुजुर्गों के मुफ़्त इलाज के लिए हम संजीवनी योजना ला रहे हैं
? इसके अंतर्गत दिल्ली के सभी सरकारी और प्राइवेट अस्पतालों में बुजुर्गों का इलाज मुफ़्त में किया जाएगा… <a href="https://t.co/iNhHvKNtlW">pic.twitter.com/iNhHvKNtlW</a>
— AAP (@AamAadmiParty) <a href="https://twitter.com/AamAadmiParty/status/1869304092796805576?ref_src=twsrc%5Etfw">December 18, 2024</a></blockquote>
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Last week, the Delhi High Court questioned the AAP government as to why the centrally sponsored Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) had not been implemented in Delhi, while it has already been implemented in the rest of the states and union territories.
The Ayushman Bharat scheme offers healthcare benefits to individuals with a coverage of up to Rs 5 lakh to protect them from the high cost of treatment in secondary and tertiary hospitals. The scheme covers both public and private hospitals that are empanelled.
Also read | <a href="https://www.wionews.com/india-news/one-nation-one-election-bills-introduced-in-lok-sabha-269-mps-vote-in-favour-198-oppose-784662">One Nation, One Election bills introduced in Lok Sabha; 269 MPs vote in favour, 198 oppose</a>
However, Delhi health minister Saurabh Bhardwaj said that the scheme was not sufficient when compared to the AAP government’s free healthcare model for the poor, as it required the underprivileged to pay for treatments that exceeded the limit of Rs 5 lakh.
Bhardwaj also suggested that the central scheme was not meeting the needs of the underprivileged and claimed that half of the patients from BJP-ruled states were being treated in Delhi’s government hospitals.
(With inputs from agencies)

Arvind Kejriwal also said that there will be no upper limit on the cost of treatment for the elderly registered under this scheme. The scheme will be implemented by the AAP government after the elections



New Delhi, India Ahead of the Delhi Assembly elections in February next year, Aam Aadmi Party (AAP) leader Arvind Kejriwal announced on Wednesday (Dec 18) that all people above 60 years of age will receive free treatment at all government and private hospitals as a part of ‘Sanjeevani Yojana’ if AAP retains power in the national capital. The former chief minister said that the registration process for the scheme will begin in the next two to three days during an event at the party headquarters. He also said that people don’t have to go anywhere to get registered for the scheme, as AAP workers will go door to door to register eligible people. Also read | India farmers' protest: 'Rail roko' agitation in Punjab, travellers may face inconvenience Kejriwal also said that there will be no upper limit on the cost of the treatment for the elderly registered under this scheme. The scheme will be implemented by the AAP government after the elections. दिल्ली के बुजुर्गों आप चिंता मत करना, आपका बेटा केजरीवाल अभी जिंदा है? ? 60 साल और उससे ज़्यादा उम्र के बुजुर्गों के मुफ़्त इलाज के लिए हम संजीवनी योजना ला रहे हैं ? इसके अंतर्गत दिल्ली के सभी सरकारी और प्राइवेट अस्पतालों में बुजुर्गों का इलाज मुफ़्त में किया जाएगा… pic.twitter.com/iNhHvKNtlW — AAP (@AamAadmiParty) December 18, 2024 × Last week, the Delhi High Court questioned the AAP government as to why the centrally sponsored Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) had not been implemented in Delhi, while it has already been implemented in the rest of the states and union territories. The Ayushman Bharat scheme offers healthcare benefits to individuals with a coverage of up to Rs 5 lakh to protect them from the high cost of treatment in secondary and tertiary hospitals. The scheme covers both public and private hospitals that are empanelled. Also read | One Nation, One Election bills introduced in Lok Sabha; 269 MPs vote in favour, 198 oppose However, Delhi health minister Saurabh Bhardwaj said that the scheme was not sufficient when compared to the AAP government’s free healthcare model for the poor, as it required the underprivileged to pay for treatments that exceeded the limit of Rs 5 lakh. Bhardwaj also suggested that the central scheme was not meeting the needs of the underprivileged and claimed that half of the patients from BJP-ruled states were being treated in Delhi’s government hospitals. (With inputs from agencies)

Arvind Kejriwal launches ‘Sanjeevani Yojana’ for free treatment of senior citizens at all Delhi hospitals

Ahead of the Delhi Assembly elections in February next year, Aam Aadmi Party (AAP) leader Arvind Kejriwal announced on Wednesday (Dec 18) that all people above 60 years of age will receive free treatment at all government and private hospitals as a part of ‘Sanjeevani Yojana’ if AAP retains power in the national capital.&nbsp;

The former chief minister said that the registration process for the scheme will begin in the next two to three days during an event at the party headquarters. He also said that people don’t have to go anywhere to get registered for the scheme, as AAP workers will go door to door to register eligible people.

Also read |&nbsp;<a href="https://www.wionews.com/india-news/india-farmers-protest-rail-roko-agitation-in-punjab-travellers-may-face-inconvenience-784880">India farmers' protest: 'Rail roko' agitation in Punjab, travellers may face inconvenience</a>

Kejriwal also said that there will be no upper limit on&nbsp;the cost of the treatment for the elderly registered under this scheme. The scheme will be implemented by the AAP government after the elections.

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दिल्ली के बुजुर्गों आप चिंता मत करना, आपका बेटा केजरीवाल अभी जिंदा है🙏 
 
🔷 60 साल और उससे ज़्यादा उम्र के बुजुर्गों के मुफ़्त इलाज के लिए हम संजीवनी योजना ला रहे हैं 
 
🔷 इसके अंतर्गत दिल्ली के सभी सरकारी और प्राइवेट अस्पतालों में बुजुर्गों का इलाज मुफ़्त में किया जाएगा… <a href="https://t.co/iNhHvKNtlW">pic.twitter.com/iNhHvKNtlW</a>
— AAP (@AamAadmiParty) <a href="https://twitter.com/AamAadmiParty/status/1869304092796805576?ref_src=twsrc%5Etfw">December 18, 2024</a></blockquote>
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Last week, the Delhi High Court questioned the AAP government as to why the centrally sponsored Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) had not been implemented in Delhi, while it has already been implemented in the rest of the states and union territories.

The Ayushman Bharat scheme offers healthcare benefits to individuals with a coverage of up to Rs 5 lakh to protect them from the high cost of treatment&nbsp;in secondary and tertiary hospitals. The scheme covers both public and private hospitals that are empanelled.

Also read |&nbsp;<a href="https://www.wionews.com/india-news/one-nation-one-election-bills-introduced-in-lok-sabha-269-mps-vote-in-favour-198-oppose-784662">One Nation, One Election bills introduced in Lok Sabha; 269 MPs vote in favour, 198 oppose</a>

However, Delhi health minister Saurabh Bhardwaj said that the scheme was not sufficient when compared to the AAP government’s free healthcare model for the poor, as it required the underprivileged to pay for treatments that exceeded the limit of Rs 5 lakh.

Bhardwaj also suggested that the central scheme was not meeting the needs of the underprivileged and claimed that half of the patients from BJP-ruled states were being treated in Delhi’s government hospitals.

(With inputs from agencies)

Ahead of the Delhi Assembly elections in February next year, Aam Aadmi Party (AAP) leader Arvind Kejriwal announced on Wednesday (Dec 18) that all people above 60 years of age will receive free treatment at all government and private hospitals as a part of ‘Sanjeevani Yojana’ if AAP retains power in the national capital.

Ahead of the Delhi Assembly elections in February next year, Aam Aadmi Party (AAP) leader Arvind Kejriwal announced on Wednesday (Dec 18) that all people above 60 years of age will receive free treatment at all government and private hospitals as a part of ‘Sanjeevani Yojana’ if AAP retains power in the national capital. The former chief minister said that the registration process for the scheme will begin in the next two to three days during an event at the party headquarters. He also said that people don’t have to go anywhere to get registered for the scheme, as AAP workers will go door to door to register eligible people. Also read | India farmers' protest: 'Rail roko' agitation in Punjab, travellers may face inconvenience Kejriwal also said that there will be no upper limit on the cost of the treatment for the elderly registered under this scheme. The scheme will be implemented by the AAP government after the elections. दिल्ली के बुजुर्गों आप चिंता मत करना, आपका बेटा केजरीवाल अभी जिंदा है🙏 🔷 60 साल और उससे ज़्यादा उम्र के बुजुर्गों के मुफ़्त इलाज के लिए हम संजीवनी योजना ला रहे हैं 🔷 इसके अंतर्गत दिल्ली के सभी सरकारी और प्राइवेट अस्पतालों में बुजुर्गों का इलाज मुफ़्त में किया जाएगा… pic.twitter.com/iNhHvKNtlW — AAP (@AamAadmiParty) December 18, 2024 × Last week, the Delhi High Court questioned the AAP government as to why the centrally sponsored Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) had not been implemented in Delhi, while it has already been implemented in the rest of the states and union territories. The Ayushman Bharat scheme offers healthcare benefits to individuals with a coverage of up to Rs 5 lakh to protect them from the high cost of treatment in secondary and tertiary hospitals. The scheme covers both public and private hospitals that are empanelled. Also read | One Nation, One Election bills introduced in Lok Sabha; 269 MPs vote in favour, 198 oppose However, Delhi health minister Saurabh Bhardwaj said that the scheme was not sufficient when compared to the AAP government’s free healthcare model for the poor, as it required the underprivileged to pay for treatments that exceeded the limit of Rs 5 lakh. Bhardwaj also suggested that the central scheme was not meeting the needs of the underprivileged and claimed that half of the patients from BJP-ruled states were being treated in Delhi’s government hospitals. (With inputs from agencies)

While Article 21 of the Constitution of India guarantees every person protection of life and personal liberty, it connotes a much wider meaning, which includes the right to human dignity, right to health, right to receive medical care etc. It encompasses within its fold some of the finer facets of human civilization which make life worth living. It is not res integra anymore that the right to health has been held to be a deemed fundamental right. Article 47 of our Constitution reinforces that it is for the state to secure the health of its citizens as its primary duty. Furthermore, Article 25 of the Universal Declaration of Human Rights, to which India is a signatory, ensures the right to standard of adequate living for health and well-being of an individual including adequate medical care and the right to security in the event of sickness, disability etc.&nbsp;

Due to the enormous challenges faced by India’s health sector, including high expenditures, low financial protection and no health insurance coverage or protection, prompting impoverishment and poverty by virtue of high medical and hospitalisation costs, the Central Government, with a view to ensure universal access to quality health care services without having to face financial hardship, conceptualised the “Ayushman Bharat Scheme”, in order to fulfil the vision of Health for All and Universal Health Coverage enshrined in the National Health Policy, 2017. The Scheme has a two-legged approach, namely (i) Health and Wellness Centres; and (ii) National Health Protection Scheme. The former seeks to construct around 1,50,000 Health and Wellness Centres across the country and ensure comprehensive primary health care services. Whereas, the latter seeks to provide a comprehensive health insurance scheme. The Central Government seeks to provide an insurance cover of Rs.5 Lakhs per family per year, with no cap on family size and age, including pre and post hospitalisation expense, by defining 1,350 medical packages covering surgery, medical and daycare treatments including medicines, diagnostics and transport. &nbsp;

The central government has allocated an amount of Rs 6,400 crores for the implementation of the scheme in the current financial year i.e. 2019-20, having benefitted over 20 lakh patients with access to much cheaper drugs till date and almost 70,000 hospitals having applied for empanelment under the said scheme. The state governments are expected to set up State Health Agencies to implement the Scheme in their respective States so that the Ayushman Bharat Scheme, being centrally sponsored, is availed by every deserving citizen of the country. It, being the bounden duty of the State Government since the subject of “Public health and sanitation; hospitals and dispensaries” falls solely under the ambit of the State List in the Seventh Schedule of the Constitution. Therefore, with the sole objective of public welfare in mind, altogether, a total of 32 States and Union Territories have signed a Memorandum with the Central Government to implement the Scheme and provide the benefits to their respective local citizens. However, it is quite cryptic as to why the government of NCT of Delhi has neither signed any Memorandum with the Central Government nor has adopted the said scheme for the benefit and welfare of its citizens. &nbsp;

The denial of benefits of the Scheme to millions of citizens of Delhi is not only violative of Article 21, but also blatantly violates the provisions of Article 14 of the Constitution, which aims to establish “Equality of Status and Opportunity” to every person.&nbsp;

Thus, the Government of NCT of Delhi is in direct abrogation of the rights and liberties of its local residents and inhabitants, juxtaposed with the citizens of other states of the country, enjoying the benefits of the Scheme. The citizens would be in a position to avail quality medical facilities all over the country under the said scheme from various hospitals that would come under the purview of the Scheme. Such denial by the Government of NCT of Delhi is further incongruous with the Doctrine of Good Governance, which categorically requires any Government to rise above their political interests and act only in public interest and for the welfare of its people.1 Public policy, is not the policy of a particular Government. 2. The political apathy of the Government of NCT of Delhi specifically lacks rationale and sensitivity towards the common citizens. It must be mentioned that political vendetta must never stand in the way of public welfare. Governments are expected to rise above the nexus of vested interests and nepotism and eschew window-dressing and that the principles of governance have to be tested on the touchstone of justice, equity, fair play. 3 In a democracy, it is legitimate for the citizens to expect that the Government of the day would treat the public interests as primary. &nbsp;

In view of the foregoing, it is trite to mention the maxim “Salus Populi Suprema Lex Esto”, which means that the health of the people must be the supreme law. It must not only be kept in books but be implemented in effect. All policies, schemes or provisions introduced in the interest of communal harmony and for the prevalence of good governance must be given effect to without any political controversy. &nbsp; 
 
(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL) &nbsp; 
&nbsp;

While Article 21 of the Constitution of India guarantees every person protection of life and personal liberty, it connotes a much wider meaning, which includes the right to human dignity, right to health, right to receive medical care etc.

While Article 21 of the Constitution of India guarantees every person protection of life and personal liberty, it connotes a much wider meaning, which includes the right to human dignity, right to health, right to receive medical care etc. It encompasses within its fold some of the finer facets of human civilization which make life worth living. It is not res integra anymore that the right to health has been held to be a deemed fundamental right. Article 47 of our Constitution reinforces that it is for the state to secure the health of its citizens as its primary duty. Furthermore, Article 25 of the Universal Declaration of Human Rights, to which India is a signatory, ensures the right to standard of adequate living for health and well-being of an individual including adequate medical care and the right to security in the event of sickness, disability etc. Due to the enormous challenges faced by India’s health sector, including high expenditures, low financial protection and no health insurance coverage or protection, prompting impoverishment and poverty by virtue of high medical and hospitalisation costs, the Central Government, with a view to ensure universal access to quality health care services without having to face financial hardship, conceptualised the “Ayushman Bharat Scheme”, in order to fulfil the vision of Health for All and Universal Health Coverage enshrined in the National Health Policy, 2017. The Scheme has a two-legged approach, namely (i) Health and Wellness Centres; and (ii) National Health Protection Scheme. The former seeks to construct around 1,50,000 Health and Wellness Centres across the country and ensure comprehensive primary health care services. Whereas, the latter seeks to provide a comprehensive health insurance scheme. The Central Government seeks to provide an insurance cover of Rs.5 Lakhs per family per year, with no cap on family size and age, including pre and post hospitalisation expense, by defining 1,350 medical packages covering surgery, medical and daycare treatments including medicines, diagnostics and transport. The central government has allocated an amount of Rs 6,400 crores for the implementation of the scheme in the current financial year i.e. 2019-20, having benefitted over 20 lakh patients with access to much cheaper drugs till date and almost 70,000 hospitals having applied for empanelment under the said scheme. The state governments are expected to set up State Health Agencies to implement the Scheme in their respective States so that the Ayushman Bharat Scheme, being centrally sponsored, is availed by every deserving citizen of the country. It, being the bounden duty of the State Government since the subject of “Public health and sanitation; hospitals and dispensaries” falls solely under the ambit of the State List in the Seventh Schedule of the Constitution. Therefore, with the sole objective of public welfare in mind, altogether, a total of 32 States and Union Territories have signed a Memorandum with the Central Government to implement the Scheme and provide the benefits to their respective local citizens. However, it is quite cryptic as to why the government of NCT of Delhi has neither signed any Memorandum with the Central Government nor has adopted the said scheme for the benefit and welfare of its citizens. The denial of benefits of the Scheme to millions of citizens of Delhi is not only violative of Article 21, but also blatantly violates the provisions of Article 14 of the Constitution, which aims to establish “Equality of Status and Opportunity” to every person. Thus, the Government of NCT of Delhi is in direct abrogation of the rights and liberties of its local residents and inhabitants, juxtaposed with the citizens of other states of the country, enjoying the benefits of the Scheme. The citizens would be in a position to avail quality medical facilities all over the country under the said scheme from various hospitals that would come under the purview of the Scheme. Such denial by the Government of NCT of Delhi is further incongruous with the Doctrine of Good Governance, which categorically requires any Government to rise above their political interests and act only in public interest and for the welfare of its people.1 Public policy, is not the policy of a particular Government. 2. The political apathy of the Government of NCT of Delhi specifically lacks rationale and sensitivity towards the common citizens. It must be mentioned that political vendetta must never stand in the way of public welfare. Governments are expected to rise above the nexus of vested interests and nepotism and eschew window-dressing and that the principles of governance have to be tested on the touchstone of justice, equity, fair play. 3 In a democracy, it is legitimate for the citizens to expect that the Government of the day would treat the public interests as primary. In view of the foregoing, it is trite to mention the maxim “Salus Populi Suprema Lex Esto”, which means that the health of the people must be the supreme law. It must not only be kept in books but be implemented in effect. All policies, schemes or provisions introduced in the interest of communal harmony and for the prevalence of good governance must be given effect to without any political controversy. (Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL)

Ayushman Bharat: Why rob Delhi of a world-class health scheme?

The private sector’s ability to provide an array of healthcare services to the common masses needs to be put under a microscope.

Many healthcare interventions, which are preventive and promotional in nature — communicable diseases, efforts to minimise pollution, improving food safety, protection from adverse health behaviour and childhood immunisation — need the help of the public sector. &nbsp;

Therefore, the core element of public health that manifests collectivity and benefits all, is essential for improving the health of the population and maintaining a healthy workforce. &nbsp;

However, the other variety of health services, which are exclusively curative in nature, can be provided by the market after charging a price.

Despite the fact that a large part of curative services is subject to a market transaction, state intervention must be considered mandatory for a majority of people, who cannot afford quality healthcare. &nbsp;

Evidence in India and other low and middle-income countries suggest that millions of people are pushed into poverty due to high out-of-pocket expenditure on accessing healthcare.&nbsp;

A recent study estimated that 55 million people had fallen below the poverty line due to exorbitant out-of-pocket health expenditure. The debilitating public health system caused by underfunding, mismanagement of staff, administrative and failure of governance, adds to the woes. &nbsp;

However, the recent rollout of Ayushman Bharat, providing financial protection to a targeted population and strengthening primary care for all citizens, covers the ground for universal health coverage. The all-encompassing approach, which does not exclude anyone from basic services, is certainly forward-looking.&nbsp;

In this scenario, the private sector plugs the gaps in the delivery of services, where they provide quality healthcare, with a price that is paid by the government.&nbsp;

The share of out-of-pocket expenditure is 63 per cent of the total health expenditure in India, which is largely used to purchase medicines, diagnostic services and related services in the private sector.&nbsp;

According to one estimate, the size of the private sector was 8 per cent after independence and in six-and-a-half decades, it has grown nine times, while the public sector has declined in absolute terms by a third of what it was, during the corresponding period. &nbsp;&nbsp;

The structure of the private sector is diverse and functions as single doctor clinics, tiny nursing homes and large corporate hospitals operating in Tier I and II cities. Add to it various health facilities run by faith-based organisations. It can also be said that private healthcare services are demanded by all income groups.&nbsp;

Though limited, there are precedents of partnership with the private sector in specific disease control programmes, without tenable strategies for a scale up.

Several models of public-private partnership (PPP) have been experimented - contract services, joint ventures, demand-side financing, telemedicine and mobile health units in several parts of the country, leading to diverse results.

The country has vast experience of buying healthcare from the private sector through government revenue in the Rashtriya Swasthya Bima Yojana (RSBY) and state- specific insurance programmes.&nbsp;

From experience, major uncertainties that drove trust deficit in the private sector were pricing, quality, transparency and accreditation of services. There are examples galore of over hospitalisation, redundant procedures and diagnostic tests inflating costs.&nbsp;

The private sector often raises prices of packages in many insurance schemes that do not deliver commensurate services. This issue assumes critical proportions. However, it is difficult to judge the merits of this argument in the absence of comprehensive costing data on different services by various types of health facilities. The unit cost of a service in a big corporate hospital is significantly different from similar service at a district-level hospital.&nbsp;

Land, building and vast administrative machinery propel costs in these hospitals. Do we really need the participation of big corporate hospitals in these schemes, where high-frequency-low cost episodes are more than the low frequency-high cost episodes? &nbsp;

We could negotiate to reserve some extremely critical procedures with a different payment mechanism in these hospitals.&nbsp;

Private hospitals have been given concessional land, customs exemption and liberal tax breaks with a commitment to reserve beds for poor patients, who would be entitled to free treatment.

But the manipulation of this provision is acute. Their behaviour is guided solely by profit motives, which is heightened by the information asymmetry in clinical practice, where the provider is more knowledgeable than the client. &nbsp;&nbsp;

Regulatory frameworks in several forms –National Pharmaceutical Pricing Authority (NPPA), Drugs Control Authority and the Clinical Establishment Act, are hampered by inadequate capacities in the public sector.&nbsp;

Despite these limitations, the private sector has certain advantages - better management of diseases, efficient utilisation of skills, accessibility, active response to patients’ need, use of technology, good hospitality and superior administration, which need to be appreciated.&nbsp;

Forgetting the dichotomy between public and private sector for the moment, can we make effective collaboration between the two to uplift provision of services? &nbsp;&nbsp;

When the scope of collaboration has widened after the rollout of PMJAY, each other’s merits and pitfalls need to be discussed for meaningful collaboration.&nbsp;

The success is contingent upon how transparent and accountable the private sector is in delivering affordable care.

For any partnership to be successful, accountability, transparency, equality, mutual obligation and commitment to achieve common objectives is the need of the hour. Is the private sector ready for this? &nbsp;&nbsp; 
&nbsp;

(This article was originally published on The DNA. Read the <a href="https://www.dnaindia.com/analysis/column-time-to-make-the-twain-meet-2726456">original article)</a>

(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL.)

The private sector’s ability to provide an array of healthcare services to the common masses needs to be put under a microscope. Many healthcare interventions, which are preventive and promotional in nature — communicable diseases, efforts to minimise pollution, improving food safety, protection from adverse health behaviour and childhood immunisation — need the help of the public sector.

The private sector’s ability to provide an array of healthcare services to the common masses needs to be put under a microscope. Many healthcare interventions, which are preventive and promotional in nature — communicable diseases, efforts to minimise pollution, improving food safety, protection from adverse health behaviour and childhood immunisation — need the help of the public sector. Therefore, the core element of public health that manifests collectivity and benefits all, is essential for improving the health of the population and maintaining a healthy workforce. However, the other variety of health services, which are exclusively curative in nature, can be provided by the market after charging a price. Despite the fact that a large part of curative services is subject to a market transaction, state intervention must be considered mandatory for a majority of people, who cannot afford quality healthcare. Evidence in India and other low and middle-income countries suggest that millions of people are pushed into poverty due to high out-of-pocket expenditure on accessing healthcare. A recent study estimated that 55 million people had fallen below the poverty line due to exorbitant out-of-pocket health expenditure. The debilitating public health system caused by underfunding, mismanagement of staff, administrative and failure of governance, adds to the woes. However, the recent rollout of Ayushman Bharat, providing financial protection to a targeted population and strengthening primary care for all citizens, covers the ground for universal health coverage. The all-encompassing approach, which does not exclude anyone from basic services, is certainly forward-looking. In this scenario, the private sector plugs the gaps in the delivery of services, where they provide quality healthcare, with a price that is paid by the government. The share of out-of-pocket expenditure is 63 per cent of the total health expenditure in India, which is largely used to purchase medicines, diagnostic services and related services in the private sector. According to one estimate, the size of the private sector was 8 per cent after independence and in six-and-a-half decades, it has grown nine times, while the public sector has declined in absolute terms by a third of what it was, during the corresponding period. The structure of the private sector is diverse and functions as single doctor clinics, tiny nursing homes and large corporate hospitals operating in Tier I and II cities. Add to it various health facilities run by faith-based organisations. It can also be said that private healthcare services are demanded by all income groups. Though limited, there are precedents of partnership with the private sector in specific disease control programmes, without tenable strategies for a scale up. Several models of public-private partnership (PPP) have been experimented - contract services, joint ventures, demand-side financing, telemedicine and mobile health units in several parts of the country, leading to diverse results. The country has vast experience of buying healthcare from the private sector through government revenue in the Rashtriya Swasthya Bima Yojana (RSBY) and state- specific insurance programmes. From experience, major uncertainties that drove trust deficit in the private sector were pricing, quality, transparency and accreditation of services. There are examples galore of over hospitalisation, redundant procedures and diagnostic tests inflating costs. The private sector often raises prices of packages in many insurance schemes that do not deliver commensurate services. This issue assumes critical proportions. However, it is difficult to judge the merits of this argument in the absence of comprehensive costing data on different services by various types of health facilities. The unit cost of a service in a big corporate hospital is significantly different from similar service at a district-level hospital. Land, building and vast administrative machinery propel costs in these hospitals. Do we really need the participation of big corporate hospitals in these schemes, where high-frequency-low cost episodes are more than the low frequency-high cost episodes? We could negotiate to reserve some extremely critical procedures with a different payment mechanism in these hospitals. Private hospitals have been given concessional land, customs exemption and liberal tax breaks with a commitment to reserve beds for poor patients, who would be entitled to free treatment. But the manipulation of this provision is acute. Their behaviour is guided solely by profit motives, which is heightened by the information asymmetry in clinical practice, where the provider is more knowledgeable than the client. Regulatory frameworks in several forms –National Pharmaceutical Pricing Authority (NPPA), Drugs Control Authority and the Clinical Establishment Act, are hampered by inadequate capacities in the public sector. Despite these limitations, the private sector has certain advantages - better management of diseases, efficient utilisation of skills, accessibility, active response to patients’ need, use of technology, good hospitality and superior administration, which need to be appreciated. Forgetting the dichotomy between public and private sector for the moment, can we make effective collaboration between the two to uplift provision of services? When the scope of collaboration has widened after the rollout of PMJAY, each other’s merits and pitfalls need to be discussed for meaningful collaboration. The success is contingent upon how transparent and accountable the private sector is in delivering affordable care. For any partnership to be successful, accountability, transparency, equality, mutual obligation and commitment to achieve common objectives is the need of the hour. Is the private sector ready for this? (This article was originally published on The DNA. Read the original article) (Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL.)

Need to collaborate efforts of private and public sector to meet healthcare objectives

BJP&#39;s &#39;Modicare&#39; came under renewed attack from the Congress leader and former finance minister P Chidambaram a day after the Union Budget. Taking to Twitter, Chidambaram referring to &#39;healthcare scheme&#39;, stated that a scheme without money is like flying a kite without a string. The kite flyer will say that the kite is flying, but there will be no kite and nothing will be flying.

&#39;&#39;Yesterday, I had said that the new HEALTH CARE SCHEME is a jumla with no money provided in the budget. Today, FM has admitted that no money has been provided and he will &#39;raise money in the future&#39;. Perfect jumla,&#39;&#39; he said in another Tweet.

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Scheme without money is like flying a kite without a string. The kite flyer will say that the kite is flying, but there will be no kite 
and nothing will be flying.
&mdash; P. Chidambaram (@PChidambaram_IN) <a href="https://twitter.com/PChidambaram_IN/status/959340415454363654?ref_src=twsrc%5Etfw">February 2, 2018</a></blockquote>
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Finance Minister Arun Jaitley in his budget speech announced a flagship national health insurance scheme that will cover about 50 crore people in India.&nbsp;

The health coverage of the scheme will be up to Rs 5 lakh per family per year for secondary and tertiary hospitalisation. &ldquo;We are slowly progressing towards universal health coverage,&rdquo; Arun Jaitley said in his budget speech, adding that the scheme will be the &ldquo;world&rsquo;s largest healthcare programme,&rdquo; Jaitley added.

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Yesterday, I had said that the new HEALTH CARE SCHEME is a jumla with no money provided in the budget. Today, FM has admitted that no money has been provided and he will &#39;raise money in the future&#39;. Perfect jumla.
&mdash; P. Chidambaram (@PChidambaram_IN) <a href="https://twitter.com/PChidambaram_IN/status/959340378120896513?ref_src=twsrc%5Etfw">February 2, 2018</a></blockquote>
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The minister said out of the 25 crore families in India, the bottom 10 crore family which constitute 40 per cent of the population will benefit from the new healthcare plan.

&quot;The poor families will now have an insurance card and can go to any hospital and show their card to avail health benefits,&quot; he said.

&quot;We can make this scheme universal, then the world will have to acknowledge that whether Obamacare became successful or not, &#39;Modicare&#39; can definitely be made successful,&quot; the finance minister said.

On the question of funding of &quot;Modicare&quot;, the minister said it was mainly an operational detail and that it would be funded by the government.

&quot;The healthcare plan is a major step in ensuring the social security of the country,&quot; the minister said.

 
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Finance Minister Arun Jaitley in his budget speech announced a flagship national health insurance scheme that will cover about 50 crore people in India.

BJP's 'Modicare' came under renewed attack from the Congress leader and former finance minister P Chidambaram a day after the Union Budget. Taking to Twitter, Chidambaram referring to 'healthcare scheme', stated that a scheme without money is like flying a kite without a string. The kite flyer will say that the kite is flying, but there will be no kite and nothing will be flying. ''Yesterday, I had said that the new HEALTH CARE SCHEME is a jumla with no money provided in the budget. Today, FM has admitted that no money has been provided and he will 'raise money in the future'. Perfect jumla,'' he said in another Tweet. Scheme without money is like flying a kite without a string. The kite flyer will say that the kite is flying, but there will be no kite and nothing will be flying. — P. Chidambaram (@PChidambaram_IN) February 2, 2018 × Finance Minister Arun Jaitley in his budget speech announced a flagship national health insurance scheme that will cover about 50 crore people in India. The health coverage of the scheme will be up to Rs 5 lakh per family per year for secondary and tertiary hospitalisation. “We are slowly progressing towards universal health coverage,” Arun Jaitley said in his budget speech, adding that the scheme will be the “world’s largest healthcare programme,” Jaitley added. Yesterday, I had said that the new HEALTH CARE SCHEME is a jumla with no money provided in the budget. Today, FM has admitted that no money has been provided and he will 'raise money in the future'. Perfect jumla. — P. Chidambaram (@PChidambaram_IN) February 2, 2018 × The minister said out of the 25 crore families in India, the bottom 10 crore family which constitute 40 per cent of the population will benefit from the new healthcare plan. "The poor families will now have an insurance card and can go to any hospital and show their card to avail health benefits," he said. "We can make this scheme universal, then the world will have to acknowledge that whether Obamacare became successful or not, 'Modicare' can definitely be made successful," the finance minister said. On the question of funding of "Modicare", the minister said it was mainly an operational detail and that it would be funded by the government. "The healthcare plan is a major step in ensuring the social security of the country," the minister said.

Scheme without money is like flying kite without string: Chidambaram mocks 'Modicare'

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