Ten days into its launch, the country’s most-ambitious health programme, Pradhan Mantri Jan Arogya Yojana – also known as Ayushman Bharat – has catered to more than 30,000 patients, with claims of ₹38.1 crore approved by the government in both public and private hospitals.

Claims approved

Up to 23,299 claims worth ₹45 crore have been submitted, of which 23,287 claims have been approved as on October 2.

Official data show that the average claim size per patient is ₹19,357.

As on date, 32,814 hospitals have applied for empanelment, of which 13,865 have been empanelled or are in the process of being empanelled. On October 1, Dinesh Arora, Deputy CEO of Ayushman Bharat, tweeted about a 67-year-old lady from Diglipur in North Andaman Islands, who was wheeled into government-run Govind Ballabh Pant Hospital at Port Blair with heavy bleeding.

She was diagnosed with cervix cancer. Sadly, people on the island, have no access to radiotherapy.

“She was flown into private-run MIOT hospital in Chennai and treated. Transportation costs were covered under the scheme,” said Arora.

However, 51-year-old labourer Prahlad Kumar, who had to travel 120 kilometers to non-profit Jan Swasthya Sahyog hospital in Bilaspur district of Chattisgarh, from neighbouring Kabirdham district, to seek treatment for stomach cancer, appears doubtful.

“I wonder if I will get the benefit of Ayushman Bharat for cancer treatment. We have very little money. Nobody in my village approached me to tell me about the new scheme,” said Prahlad.

No Ayush Mitra

Sushil Patil, medical co-ordinator at the hospital, informed BusinessLine that an ‘Ayush Mitra’ has not yet been appointed in the hospital by the government, despite the hospital being empanelled in the scheme.

“We are also facing issues logging into the scheme portal. We have prepared claims for close to 20 cancer patients who are waiting to be reimbursed, but we are facing hiccups with the scheme.

“Considering that the Chief Minister’s Health Scheme and previously-run Rashtriya Swasthya Bima Yojana have been discontinued and Ayushman Bharat is yet to start, the transition is not smooth and patients are left in the lurch,” said Patil.

Indu Bhushan, CEO of Ayushman Bharat, said: “We will ensure that the roll-out starts at the earliest in Jan Swasthya Sahyog. They are an important partner for us.”

Non-BJP States resist

While 31 States and Union Territories are on board, five States, all of which are not run by the BJP, are resisting from participating in the scheme, including Delhi (Aam Aadmi Party), Odisha (Biju Janta Dal), Punjab (Congress), Kerala (Left Democratic Front) and Telangana (Telangana Rashtra Samithi).

Kerala, which was massively affected by the recent floods, is refusing to join unless it gets more clarity on the scheme.

B Ekbal, Member, Kerala State Planning Board, said that the State had appointed a five-member committee to negotiate with the Central government.

“If the Ayushman Bharat is to be implemented, then the number of beneficiaries will come down from 41 lakh as they exist in Rashtriya Swasthya Bima Yojana (RSBY) at 21.5 lakh.

“We currently give treatment under 1,785 disease packages, but in Ayushman, there are only 1,350 packages. There is no clear indication towards the premium to be paid by the Central government. Whatever it is, this will result in a tremendous burden for the State government,” said Ekbal.

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