Bengaluru: Since its inception in 2018, the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana Arogya Karnataka (AB-PMJAY-ArK) health assurance scheme has benefited about 55 lakh people and Rs 6286. 7 crore has been reimbursed to hospitals towards their treatment.
The health department has seen an over 600 per cent increase in reimbursements till 2022-23 compared to when the scheme started in 2018-19. However, the number of people who possess AB-PMJAY-ArK cards remains a measly 27 per cent of the targeted 5. 1 crore APL or BPL ration cardholders, the scheme’s target population.
Health commissioner Randeep D said AB-PMJAYArK cards are not mandatory, and people can get treatment even with a ration card or APL/BPL card. Since the state follows the ‘assurancemodel’ and not the ‘insurance model’, all 5. 1 cr people are assured of treatment.
Dr CM Lakshmana, professor, Population Research Centre, ISEC, Bengaluru, whose research revolves around implementation of the scheme, concurred that the efficacy of the scheme was beyond the number of cards issued and people were using ration cards to availcoverage under the scheme.
On the flip side, a high enrolment, did not naturally mean higher coverage. He said coverage in districts such as Kodagu and Udupi is relatively high — 39. 6 per cent and 28. 6 per cent — yet delivery of services under the scheme is low in these districts. Also, one reason for high enrolment could be their small populat ion size compared to other districts.
However, coverage could be anything from private hospitals referring patients to other hospitals due to lack of beds, staff, or emergency facilities, to the population having a higher development index, hence lesser health expenditure.
While talking to beneficiaries, Lakshmana revealed he did learn of in stances where hospitals refused to treat patients. He said that it highlights the need for more bed strength in public health facilities at the tertiary-level to accommodate more patients.