Performance of PM-JAY Scheme: UPSC Daily Important Topic |23 December 2022

Performance of PM-JAY Scheme

• Most states joined hands with the centre – More than 90% states have joined the PM-JAY scheme enabling wider coverage and standardised model of healthcare insurance across the country.

• More than 17 crore beneficiaries have received the Ayushman Bharat Card

• More than 2 crore treatments have been provided under the scheme.

• About half of the beneficiaries of these treatments are women.

Issues

• Low utilization during the pandemic – out of the total eligible population only 0.52 million COVID-

19 hospitalisations were covered under the scheme.

• Private hospitals count for maximum PM-JAY hospitalisations – This points to the fact that private sector participation is important in health intervention. At the same time it shows the poor quality and availability of public health care.

• Low hospital empanelment – Has proven to be a major constraint especially in small towns and villages.

• Exclusion – Ayushman Bharat has a restrictive eligibility criteria based on older data (SECC 2011).

The criteria needs to be liberalised and brought in line with latest data to reduce exclusion.