Opinion | PMJAY: The promises and challenges of a bold experiment
No actuarial database is available to yield a probability distribution of the expected number of different health episodes requiring different treatments at varying costs
The Narendra Modi government is better known for its economic programmes such as infrastructure and ease of doing business, than its social programmes. But two of its most ambitious programmes are related to health. The first is the Swachh Bharat programme, which the Prime Minister announced in his very first Independence Day speech. This programme, directed at eliminating the high incidence of open defecation, has been under implementation for nearly four years (Swachh Bharat Mission: A remarkable transformation). In contrast the Ayushman Bharat—Pradhan Mantri Jan Arogya Yojana (PMJAY), a health insurance scheme announced in the last budget, will only be launched on 23 September, towards the fag end of this government’s tenure. It will take a couple of years before this programme can be objectively assessed. However, the promises and possible challenges deserve close scrutiny as it is arguably the most ambitious social health insurance (SHI) programme ever launched anywhere in the world. Such an ex-ante scrutiny need not be purely speculative as the main components of the programme are now known and there is a wealth of SHI experience from many other countries.