70^th BPSC Mains

Introduction

• Begin with a powerful quote or fact to set the tone.
  E.g., “Health is the greatest gift,” said the Buddha. Yet, access to quality healthcare remains elusive for many in India.
• Define Universal Health Coverage (UHC) – ensuring all people have access to needed health services without financial hardship.
• Briefly introduce Ayushman Bharat as a flagship scheme aiming to transform India’s health landscape.
• End the intro with a thesis statement: Ayushman Bharat represents India’s bold step towards achieving UHC by integrating preventive, promotive, curative, and financial protection strategies.

Body

Background: India’s Healthcare Landscape

• Describe the health indicators and challenges:
  • Low public health spending (~2% of GDP)
  • High Out-of-Pocket Expenditure (OOPE ~55%)
  • Urban-rural disparity
  • Lack of insurance coverage
• Mention global context – India's commitment to SDG 3 (Good Health and Well-being)

Ayushman Bharat: A Two-Pronged Approach

1. Health and Wellness Centres (HWCs)

• Objective: Strengthening primary healthcare.
• Services: Free diagnostics, medicines, NCD screening, mental health, maternal and child health.
• Target: Convert 1.5 lakh sub-centres and PHCs into HWCs.
• Significance: Preventive & promotive healthcare.

2. Pradhan Mantri Jan Arogya Yojana (PM-JAY)

• The world’s largest health assurance scheme.
• Covers 10.74 crore vulnerable families (~50 crore individuals).
• Health cover: ₹5 lakh per family per year.
• Cashless treatment at empaneled public/private hospitals.
• Portability across India.

Ayushman Bharat and Universal Health Coverage

• Accessibility: Reaching underserved areas through HWCs.
• Affordability: Financial protection from catastrophic health expenses via PM-JAY.
• Availability: Expanding hospital network through empanelment.
• Quality: Setting service-level benchmarks, improving hospital standards.
• Equity: Prioritizing socio-economically disadvantaged groups.

Achievements So Far

• Over 5 crore hospital admissions under PM-JAY.
• Significant reduction in OOPE.
• Empowering women: 47% beneficiaries are women.
• Enhanced digital health ecosystem via ABDM (Ayushman Bharat Digital Mission).

Challenges and Limitations

• Coverage gaps: Exclusion errors in SECC-based targeting.
• Awareness: Low levels in rural areas.
• Quality control: Monitoring private hospitals and preventing fraud.
• Infrastructure: Weak PHC systems in some states.
• Human Resources: Shortage of trained health professionals.

Way Forward / Reforms Needed

• Expand the beneficiary base beyond SECC list.
• Strengthen last-mile delivery through ASHA & ANM workers.
• Ensure interoperability with state health schemes.
• Incentivize the private sector in Tier-2, Tier-3 cities.
• Promote digital health platforms and telemedicine.
• Improve health financing – aim for 2.5-3 % of GDP in public spending.
• Community engagement for behavioral change and awareness.

Conclusion

• Reiterate: Health is foundational to productivity, prosperity, and dignity.
• Ayushman Bharat is not just a scheme but a paradigm shift in healthcare delivery.
• With political will, cooperative federalism, and citizen awareness, it can bring India closer to the dream of Universal Health Coverage.
• “Universal health coverage is the single most powerful concept that public health has to offer.”— Dr. Margaret Chan, Former WHO DG
• End with a hopeful, forward-looking statement: “A healthy India is a strong India, and Ayushman Bharat lights the path.”