Good health policies of the country make a significant impact on its economy through building good health status of the population. The latest Economic survey states that India ranks 179 out of 189 countries in prioritisation accorded to healthcare in its government budget. Indian Government is committed to increase public spending from current 1.35 % to 2.5 % of GDP in the near future. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is one such initiative to achieve this goal. It is expected to be a game changer in India. As Prime Minister Narendra Modi mentions “It is a holistic solution for a healthy India”. It strives to give free access to medical services to nearly 40 per cent of the population which covers around 50 crore people along with free primary, secondary and tertiary level medical care by providing a health insurance of Rs 5 lakh per family per year. The current budget has a higher allocation for Ayushman Bharat Digital Mission through building national digital health ecosystem.

The latest figures on Ayushman Bharat portal show that 17.35 crores person till date received Ayushman Bharat cards and 2.61 crores person availed the facility of hospital admissions. It is only a humble start. We need to see how effectively we can reach the vulnerable population in order to make it more effective. It can be argued that the effectiveness of the Ayushman Bharat programme depends on overcoming many other challenges besides an increase in budget allocation. One needs to see how the interests of different stakeholders are synergized together. Let’s look into some of them.

Central and state governments are some of the key stakeholders. It is important to notice that though Ayushman Bharat is rolled out by the central government, its implementation responsibility lies with the state governments. Many state governments such as Karnataka, Andhra Pradesh, Maharashtra, etc. have already launched their flagship health programmes. The states can either join this programme by subsuming their existing plans or run their own health programmes. Many state governments are still sceptical about joining hands with the central governments due to fear of losing autonomy.

The role of public healthcare in providing primary healthcare is very crucial for creating the nexus between primary and secondary healthcare. Inadequate availability of public healthcare infrastructure in terms of number of primary healthcare centres, sub-centres, and other infrastructure has been a chronic problem in our country since independence. Though the programme has an ambitious plan to build 1,50,000 Health and Wellness Centres (HWCs) by transforming the existing centres, it is difficult to implement it on the ground. It means the success of the programme depends on voluntary participation of private healthcare sector, especially private hospitals. The programme may benefit the private hospitals in boosting the demand for many special or super specialised treatments and scaling up their operations. Approximately 23,000 private hospitals have empanelled in this scheme. They are facing many challenges such as low fixed rates per surgery, prevalence of fraudulent cases and complicated reimbursement processes.

Private health insurance sector acts as a major pillar of the programme. The state governments ask for a competitive bidding from the insurance companies for accessibility of health insurance to masses. This might help insurance companies to scale-up very fast and reduce their average cost of customer acquisition. At the same time, they may run a high risk of reducing the premium charges to a low level where they may become unviable.

It is expected that firms operating in pharmaceuticals, diagnostics medical device and digital healthcare will act as a support system to the entire health eco-system. MedTech companies using technologies such as virtual reality, artificial intelligence, wireless sensors, 3D printing, digital healthcare can be used to collate and analyse data, bring down the costs and reach the bottom of the pyramid section effectively.

In a nutshell, we can say that the success of this programme depends on the development of skilled manpower. Healthcare workers require additional skills such as empathy, trustworthiness and communication skills along with technical and managerial skills. They are hard to develop in the short-run. India needs to have good quality healthcare education institutes to create such skillsets. Successful implementation of this programme will not only take India ahead on the global front in improving the health status but also in creating a strong base for future economic growth. The key of successful implementation depends on i) creating a mechanism to see that all the stakeholders are benefitting, ii) bringing coordination between different stakeholders, and iii) creating vigilant monitoring system to control the quality.