Asghar Ali*, who started a hospital to serve the poor in Bihar, explains why PM Ayushman Bharat has remained a non-starter in the state
I was an engineer by profession. But I had some other calling. I wanted to be an entrepreneur in a field where I could to do service to people. Initially, I focused on social work only. During the period, I realized the pain of poor people when it comes to treatment of illness, majorly related to surgeries. Hospitals would charge exorbitant prices for surgeries. Many poor patients are forced to take loans on extremely high interest for their treatments.
I observed the problem up-close in Bihar and decided to solve it through entrepreneurship. In 2011, I launched my own private hospital at Katihar in Bihar with an aim to provide healthcare facilities to people below the BPL category, under the health insurance scheme of the government.
In 2008, the then government had launched Rashtriya Swasthya Bima Yojana (RSBY) for poor. The scheme aimed to provide health insurance coverage to the unrecognised sector workers belonging to the BPL category and their family members. It provided for cashless insurance for hospitalisation in public as well as private hospitals.
Later, in 2018, this scheme was renamed as Ayushman Bharat Yojana. Though this was the old scheme, but the renaming process rejuvenated it. Thousands of private hospitals were empanelled and poor were majorly benefited for the next two years. BPL category people could get surgeries done at the best of private hospitals in their area without paying any penny.
But now, the scheme seems to be completely in a dormant state. Private hospitals were the backbone of this scheme and supported the government immensely to make it successful. Now, it seems that the government has turned away all its focus from the scheme.
The lapses in the implementation of the scheme are happening at three levels — district administration, state government and policy makers at the central government.
The district administration is the first touch point which has the responsibility to empanel as many private hospitals, under the government scheme, which could provide treatments to poor. The process of enlisting of private hospitals seem to be completely stopped. Applications of private hospitals, requesting to enlist under the scheme, have been pending with the local administration for months.
Besides, the state government, which has the responsibility to implement it, seems to be completely disinterested in it.
The third problem is with the policy makers of the central government. The kind of packages they have created for hospitals in not sustainable any longer. They have to bring changes in that. Besides, the problem is with the distribution of packages. The reimbursement of hospitals has also been getting delayed for months. The question is, how will hospitals pay off doctors, nurses and people working in different departments without getting reimbursed for the services they provided for the government?
I think the government is now seriously lacking behind in providing healthcare services to poor. Now, there are more announcements of schemes but far less implementation of them. It’s high time that the government fills the gap in the system and implement the scheme on the ground.
*The name of the narrator was changed on request
As told to Md Tausif Alam