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Long road ahead: on Ayushman Bharat scheme

Budgetary support must be strengthened to make Ayushman Bharat a success
Ayushman Bharat has been rolled out as a health protection(सुरक्षा/संरक्षण) scheme that will provide(प्रदान करना/मुहैया करना)guaranteed access to treatment that is free at the point of delivery to about 40% of the population selected on the basis of censused(जनगणना/संवेदना ) socio-economic indicators(संकेतक). It is the essential(आवश्यक/अनिवार्य सेवा) first step on the road to universal health coverage, although(हालांकि) it has been launched by the NDA government quite late in its term(अवधि),possibly with an eye on the 2019 general election. Since the Centre has announced that 10.74 crore families identified through Socio-Economic Caste Census data will be given an annual ₹5 lakh cover under the Pradhan Mantri Jan Arogya Yojana (the insurance component of the scheme), the question of eligibility(योग्यता/उपयुक्तता) appears settled. But the late start makes it virtually(वास्तव में/असल में ) impossible for all those who are technically insured to avail of the services that state agencies must make available, within a reasonable time-frame. And, the allocation of just ₹2,000 crore during(दौरान) the current year to the PMJAY cannot provide the promised cover to the large population sought(प्रयास करना/मांगा ) to be included(शामिल थे।). Not all States and Union Territories are in a position to raise(बढ़ाना/ऊपर उठाना) their own share, and a few have not even joined the scheme. The challenge of funding, therefore, remains. And without adequate(पर्याप्त) budgetary commitments, theimplications(आशय/उलझाव) of pooling the financial risk for such a large segment(खंड/भाग) of the population through insurers or state-run trusts or societies make the outcomes uncertain(अनिश्‍चित/परिवर्तनशील) .

Guaranteeing health-care access using private or public facilities presumes(मानना/तर्क करना) tight cost control. In the case of the PMJAY, this is to be achieved using defined treatment packages for which rates are prescribed(निर्धारित). Costs are a contested(विवादास्पद) area between the care-providers and the Centre, and many for-profit hospitals see the government’s proposals as unviable. In the absence of adequate preparation, the Ayushman Bharat administration is talking of a rate review. More importantly, a lot of time has been lost in the NDA government’s tenure(कार्यकाल), when State governments should have been persuaded to regulate the hospital sector under the Clinical Establishments(प्रतिष्ठानों/स्थापना) (Registration and Regulation) Act, which dates back to 2010. The law broadly provides for standardisation(मानकीकरण) of facilities and reasonable rates for procedures. Apprehensions(आशंकाओं/हिरासत) of fraud have prompted Ayushman Bharat administrators to announce that some key treatments should be availed through public sector institutions. But public facilities have been neglected(नजरअंदाज कर दिया/उपेक्षित) for long. Going forward, there are some clear imperatives(अनिवार्यताओं). It is essential to reduce(कम करना) the pressure on secondary and tertiary hospitals for expensive(महंगा/बहुमूल्य) treatments by investing in preventive(निवारक/निरोधक) and primary care facilities. Here, the 150,000 health and wellness centres of the National Health Protection Mission can play a valuable role. The first-order priority should be to draw up a road map for universal health coverage, through continuous upgradation of the public sector infrastructure.

 

Important Vocabulary

 

1.Sought(प्रयास करना/मांगा )
Synonyms: desired, hunted, needed

2.Implications(आशय/उलझाव
Synonyms: conclusion, connotation, indication, meaning, overtone,,
Antonyms: measurement, proof, reality, truth

3.Contested(विवादास्पद)
Synonyms: debated, argued, challenged, impugned, questioned

4.Apprehensions(आशंकाओं/हिरासत)
Synonyms: alarm, disquiet, doubt, dread, foreboding
Antonyms: belief, calm, calmness, certainty, confidence

5.Preventive(निवारक/निरोधक)
Synonyms: precautionary, defending, defensive, protective

6.Imperatives(अनिवार्यताओं)
Synonyms: precautionary, defending, defensive, protective

7.Tenure(कार्यकाल
Synonyms: administration, occupation, ownership, regime, reign
Antonyms: misconception, misunderstanding, release

8. Essential(आवश्यक/अनिवार्य सेवा)
Synonyms: crucial, fundamental, imperative, indispensable, main
Antonyms: auxiliary, extra, inessential, minor, needless

 

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