“2000 families of this village have been identified who are BPL (Below Poverty Line) and will benefit from this. The scheme includes medical expenses that covers around Rs. 5 lakhs per family,” Dr. Santosh Kumar, Chief Medical Officer, Banda district of Bundelkhand, is the man of the moment, as he explains how the Pradhan Mantri Jan Arogya Yojana (PMJAY), under the Ayushman Bharat aegis, resonates with his district. Banda now has three hospitals that come under the PMJAY bracket – men, women, and children – and all three are currently seriously short-staffed.
The PMJAY, launched by the PM in his characteristic grand manner at an event in Ranchi on September 23, is touted to be one of the biggest health schemes in healthcare history in the world. Essentially entailing the provision of annual health insurance cover of 5 lakh rupees to poor urban and rural families, the policy is meant to be implemented through existing government district hospitals as well as empanelled private hospitals in the country.
Three weeks into the official launch of the scheme in Banda, we decided to look at its state of execution in a district where 78,000 urban families and 1,12, 064 rural families have been identified as the rightful beneficiaries thus far. The Banda District Hospital (Men) has a shortfall of 15 out of 27 medical professionals. Although Kumar clarifies, “We do have doctors, we just don’t have enough surgeons, for which we have already informed the authorities. Hopefully, the surgeons will be posted soon and then we will be able to provide surgical facilities as well. In the meanwhile, we send all our patients requiring surgery to our referral centre.” This referral centre, is Kanpur Medical College situated 150 kilometres away, which takes nothing short of four hours to reach from Banda. There’s something deeply ironic about the poor spending money to reach a hospital to avail of the “free” surgery that it might just be too late for, we suggest, but Kumar is at a loss for words.
At the district hospital for women, things are only marginally better, with the shortage being three out of a total of 15 required doctors. Dr. Usha Singh, Chief Medical Officer (Women), had only non-committal answers about the expected success of the scheme to offer, “Since it is the Prime Minister’s scheme, we will do our best to make it a success,” was all she had to say.
One much-talked about feature of the PMJAY is that there is no cap on the number of members in a family covered under the scheme. This, though, is still not as magnanimous as promised since the insurance cover has not been made proportionate to the number of members in a family. This would mean that be it a family of four or eight, the cover would remain at 5 lakh rupees, thus chipping away at the cover provided to each person depending on the size of his or her family.
Ved Sharma, looking to get a kidney surgery, has a lot of hopes pinned onto the PMJAY, “I found out about it through a survey that was conducted in our village, which is when I immediately came to get my card made. They already had a list of eligible beneficiaries based on data from the 2011 census, so I had to wait.” What about the execution of the policy thus far, we ask. “Well”, he says. “It is a new scheme so we cannot say much. But if this works, then there is nothing like it.”
Ashish Kumar, the Arogya Mitra, loosely translating as the guy on the local level who’s assigned the DTP kind of work, can’t seem to look up from his phone even for a second, as we ask him questions. He tells us that he’s been assigned to work for the “card generation process”. Scrolling down his computer screen, he shows us lists upon lists of beneficiaries, “I have just logged into the website. See, now I will put in their mobile numbers.” Ashish’s phone comes in handy for taking pictures too of the beneficiaries and potential beneficiaries who come to start off the process of accessing the world’s most ambitious healthcare yojna. They’ve been told that too.
This Khabar Lahariya article first appeared on The Wire.