(Photo: Mint)
(Photo: Mint)

PMJAY spending gives a boost to govt’s focus on tertiary care

  • The top tertiary specialities for treatment were cardiology, cardiothoracic, vascular surgery, orthopaedics
  • The estimated proportion of all deaths due to NCDs rose from 37.09% in 1990 to 61.8% in 2016, says ICMR report

New Delhi: In a reflection of the burden posed by mounting treatment costs for non-communicable diseases (NCDs) in India, around 77% of money spent under the Ayushman Bharat scheme has been on tertiary healthcare. According to the latest data available with ministry of health and family welfare, around 900,000 patients have availed treatment benefits worth 1,210 crore under the scheme so far.

Out of the total expenditure, the maximum amount of 931.7 crore was spent on treatment of non-communicable diseases. The scheme is officially called Pradhan Mantri Jan Arogya Yojana (PMJAY).

The top tertiary specialities for treatment based on admissions amount were cardiology, cardiothoracic and vascular surgery, orthopaedics, urology and neurosurgery, the data shows.


“Major focus of PMJAY is on tertiary care which so far has been beyond the reach of poor which includes treatment for cancer, heart, respiratory and kidney diseases. The incidence of non-communicable diseases such as stroke, heart and kidney diseases is dramatically increasing in the country, which are also more expensive to treat as compared to the traditional communicable diseases," said Indu Bhushan, chief executive of Ayushman Bharat-PMJAY. “Poor people can’t afford these treatments. Either, they die, sell their productive assets or get burdened by huge debt. Ayushman Bharat has proven to be a saviour for poor Indians," he said.

According to the World Health Organization (WHO), the rising incidence of diabetes and other NCDs is driven by a combination of factors—rapid urbanization, sedentary lifestyles, unhealthy diets, tobacco use and increasing life expectancy. The health agency has also recognized diabetes as a growing challenge in India with estimated 8.7% diabetic population between the age group of 20 and 70 years. Doctors say that people with diabetes are also more likely to have risk factors which increase chances of having heart diseases or strokes.

According to Indian Council of Medical Research (ICMR) India state-level disease burden study report ‘India: Health of the Nation’s States’, released in 2018, the estimated proportion of all deaths due to NCDs has increased from 37.09% in 1990 to 61.8% in 2016. As per the National Family Health Survey (NFHS-2015-16), 11% of women (1 in 10) and 15% of men (1 in 7) of age 15-49 are hypertensive. In India, the Global Disease Burden (GBD) 2015 ranks chronic kidney disease as the eighth leading cause of death.

“NCDs such as stroke, kidney and heart diseases are being diagnosed fast in rural population also. It impacts the poor the most as their treatment causes catastrophic expenditure and further worsens their poverty situation. With Ayushman Bharat, more and more patients suffering from NCDs are being saved that earlier couldn’t afford the expensive treatment costs," J.P. Nadda, Union health minister told Mint.

PMJAY dubbed ‘Modicare’ and labelled the world’s largest health insurance cover, aims to provide health insurance to nearly 40% of the population—i.e. more than 100 million poor and vulnerable families by providing coverage from secondary and tertiary hospitalizations. The premium is paid by the government and the scheme offers a health cover of 5 lakh per family per year, targeting families belonging to poor and vulnerable population based on Socio-Economic Caste Census (SECC) database. The finance ministry had in February 2018 initially announced an outlay of 2,000 crore.

The health ministry in March 2018 announced an allocation of 10,000 crore to Modicare for next two years. Nadda had said that more funds will be provided accordingly.

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