National Health Protection Scheme

INTRODUCTION

The National Health Protection Scheme (NHPS) was a healthcare insurance program proposed by the Government of India in 2018. It was renamed Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and was launched on 23 September 2018. The scheme aimed to provide health coverage to over 100 million poor and vulnerable families in India, who were identified based on the Socio-Economic Caste Census (SECC) data. Under the scheme, eligible families were entitled to receive up to INR 5 lakhs (approximately USD 6,700) per year for hospitalization expenses. The scheme also aimed to improve the infrastructure of healthcare facilities in India, including the development of new hospitals, upgrading existing facilities, and increasing the number of healthcare professionals. The NHPS/AB-PMJAY was one of the largest healthcare insurance programs in the world and was considered a significant step towards achieving universal healthcare coverage in India.

ADVANTAGES OF THE NATIONAL HEALTH PROTECTION SCHEME

The National Health Protection Scheme (NHPS), now known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), has several advantages:

1. Financial Protection: The scheme provides financial protection to poor and vulnerable families by covering their hospitalization expenses up to INR 5 lakhs per year. This reduces the out-of-pocket expenditure on healthcare, which is a significant burden for many families in India.

2. Improved Access to Healthcare: The scheme aims to improve the accessibility of healthcare facilities for poor and vulnerable families, especially those residing in rural areas. This is achieved by developing new hospitals, upgrading existing facilities, and increasing the number of healthcare professionals.

3. Universal Health Coverage: The NHPS/AB-PMJAY is a significant step towards achieving universal health coverage in India. By covering over 100 million poor and vulnerable families, the scheme aims to ensure that everyone has access to essential healthcare services.

4. Reduced Health Inequalities: The scheme targets poor and vulnerable families, who are often unable to afford healthcare. By providing financial protection and improving access to healthcare, the NHPS/AB-PMJAY helps to reduce health inequalities in India.

5. Job Creation: The scheme has created several employment opportunities, especially in the healthcare sector. This includes the development of new hospitals, upgrading existing facilities, and increasing the number of healthcare professionals.

STRATEGY OF NATIONAL HEALTH PROTECTION SCHEME

The National Health Protection Scheme (NHPS), now known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), has the following strategies:

1.  Identification of Beneficiaries: The first step in the implementation of the scheme was the identification of eligible families. This was done using the Socio-Economic Caste Census (SECC) data, which helped in identifying the poor and vulnerable families who were eligible for the scheme.

2.  Empanelment of Healthcare Providers: The scheme aims to improve the accessibility of healthcare facilities for poor and vulnerable families by impaneling both public and private healthcare providers. The empanelment process includes the assessment of healthcare facilities based on certain quality criteria.

3. Cashless Treatment: The scheme provides cashless treatment to eligible beneficiaries. This means that they do not have to pay for the hospitalization expenses, and the payment is made directly to the healthcare provider.

4. Information Technology: The scheme has adopted information technology (IT) to improve the efficiency of the implementation process. The IT platform helps in the identification of beneficiaries, empanelment of healthcare providers, and processing of claims.

5. Public Awareness: The scheme aims to create public awareness about the scheme and its benefits. This is done through various mediums, including mass media campaigns, community-level meetings, and public events.

MAJOR IMPACT OF THE NATIONAL HEALTH PROTECTION SCHEME

• Universal Health Coverage: The NHPS Aims To Provide Health Insurance Coverage To Over 100 Million Poor And Vulnerable Families, Which Would Cover Around 500 Million Individuals. This Scheme Will Significantly Increase The Coverage Of Health Insurance In India And Bring The Country Closer To Universal Health Coverage.
• Financial Protection: The NHPS Will Provide Financial Protection To Families Against High Healthcare Costs. Covering The Cost Of Hospitalization Will Help To Reduce The Out-Of-Pocket Expenses For Medical Treatment. This Will Prevent Families From Falling Into Poverty Due To Catastrophic Health Expenses.
• Improved Access To Healthcare: The NHPS Will Enable Families To Access Healthcare Services Without Worrying About The Cost. This Will Encourage People To Seek Medical Treatment At The Earliest, Which Will Improve Health Outcomes And Reduce The Burden Of Disease.
• Boost To Healthcare Infrastructure: The NHPS Is Expected To Lead To A Surge In Demand For Healthcare Services, Which Will Encourage Private Sector Investment In Healthcare Infrastructure. This Will Create Job Opportunities And Improve The Quality Of Healthcare Services In The Country.
• Better Health Outcomes: The NHPS Is Expected To Improve Health Outcomes By Providing Access To Preventive, Promotive, And Curative Healthcare Services To A Large Section Of The Population. This Will Reduce Morbidity And Mortality Rates In The Country.

WHO BENEFITS UNDER NATIONAL HEALTH PROTECTION SCHEME?

• The National Health Protection Scheme (NHPS), Also Known As Ayushman Bharat Or Pradhan Mantri Jan Arogya Yojana (PMJAY), Is A Health Insurance Scheme Launched By The Indian Government. It Aims To Provide Financial Protection To Around 10 Crore Poor And Vulnerable Families In India.
• Under The NHPS, Eligible Beneficiaries Can Avail Of Cashless Hospitalization For The Treatment Of Serious Illnesses And Medical Procedures. The Scheme Covers Both Pre-Existing And Newly-Diagnosed Medical Conditions.
• The Beneficiaries Of The NHPS Are Identified Based On The Socio-Economic Caste Census (SECC) Database, Which Is A Database Of Households In India. The Scheme Covers Families Who Have Been Identified As Poor And Vulnerable Based On Certain Criteria, Such As Households Without A Male Member Aged Between 16 And 59 Years, Households Without A Disabled Member, Landless Households, And So On.
• Overall, The NHPS Aims To Benefit The Poor And Vulnerable Sections Of Society In India By Providing Them With Access To Quality Healthcare Without Having To Worry About The Financial Burden Of Medical Expenses.

CONCLUSION

In conclusion, the National Health Protection Scheme (NHPS) is an ambitious healthcare initiative launched by the Indian government to provide financial protection to around 10 crore poor and vulnerable families in India. The scheme aims to provide cashless hospitalization for the treatment of serious illnesses and medical procedures, covering both pre-existing and newly-diagnosed medical conditions. By identifying beneficiaries based on the Socio-Economic Caste Census (SECC) database, the scheme aims to ensure that the poor and vulnerable sections of society have access to quality healthcare without the fear of financial burden. The NHPS is a significant step towards achieving universal health coverage and reducing the financial burden of healthcare on the poor in India. However, the successful implementation of the scheme requires effective coordination between the government, insurance providers, and healthcare providers.