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4) Out of Pocket Expenditure is one of the major challenges in improving status of healthcare in the country. Now that Ayushman Bharat has tried to address this problem, examine the issues involved and highlight the lessons that can be learnt from RSBY while implementation of Ayushman Bharat?(250 words)

Topic – Issues relating to development and management of Social Sector/Services relating to Health.

4) Out of Pocket Expenditure is one of the major challenges in improving status of healthcare in the country. Now that Ayushman Bharat has tried to address this problem, examine the issues involved and highlight the lessons that can be learnt from RSBY while implementation of Ayushman Bharat?(250 words)

Financialexpress

Why this question

Out of pocket expenditure on account of healthcare is a major reason why people are thrust into poverty in our country. With ayushman Bharat this issues is attempted to be addressed and lessons from previous health insurance scheme such as RSBY will come in handy. Hence this question.

Key demand of the question

The question expects us to first bring out the problems caused by out of pocket expenses. Thereafter, we need to explain how Ayushman Bharat tries to address the issue and also the problems arising because of this. We also need to explain the lessons that can be drawn from RSBY so that we are in a better position to design policies that tackle out of pocket expenditure.

Directive word

Examine – When you are asked to examine, you have to probe deeper into the topic,  get into details, and find out the causes or implications if any .

Structure of the answer

Introduction – Highlight the problem of OoPE in healthcare. According to the latest National Health Accounts estimates among different sources of healthcare financing, 67% of the total health expenditure comes from households’ pockets. At the national level, of the Rs 3,826 spent on healthcare per capita, Rs 2,394 is OOPE. In this manner, catastrophic health expenses push about 7% of the population below the poverty threshold every year.

Body

  • Explain about Ayushman Bharat and how it tries to address this issue
  • Discuss the issues arising out of the design of this scheme
    • One, similar to the RSBY, outpatient expenditure, which forms a major part of OOPE, has been left out of the ambit of the AB-NHPM.
    • Two, relying on a single rate card for the entire country could possibly limit private sector participation.
    • Three, preparing the entire medical procedure list at the central level is a potentially suboptimal move, given the heterogeneity in healthcare needs across the country.
  • Explain what lessons can be drawn from our experience with RSBY which can help us in better targeting the problem of OoPE
    • AB-NHPM scheme, in its current form (similar to the RSBY), may not be able to account for the rising private players’ participation in the Indian healthcare sector. The increase in compensation holds value only when it is able to induce insurance coverage for healthcare services provided by the private sector. From 1996 to 2016, the participation of the private sector in providing healthcare services has been increasing at a quick rate in urban areas, while remaining more or less constant in rural areas. Etc

Conclusion – Give your view on the effectiveness of Ayushman Bharat and discuss way forward.