Editorial 1 : A wider net
Context: Ayushman Bharat health insurance for senior citizens
Universalising Healthcare
- Government’s decision to extend the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to senior citizens above the age of 70 is a significant step towards universalising healthcare in the country.
- The Rs 5 lakh annual health coverage will benefit about six crore people, roughly 5% of the country’s current population.
Need for Health Coverage for Senior Citizens
- Increasing lifespans and an increasing number of people ageing in the next three decades.
- 20% of India is likely to be over the age of 70 by 2050.
- Dealing with the challenges of this demographic transition requires far-reaching changes in welfare policies.
- Today, barely 20% of the elderly are covered by safety nets such as the CGHS, Rashtriya Swasthya Bima Yojana and employer-funded health schemes.
Unfinished task
- AB-PMJAY has covered 7.37 crore hospital admissions since 2018. It is significant in India where out-of-pocket expenditure (OOPE) on health is often a reason for crushing poverty.
- But in India OOPE constitutes 50% of all health expenses, more than two-and-half times the global average.
- It is a common practice for doctors at premier government hospitals to dupe poor patients and bypass the government health insurance scheme.
- Doctors misinform already stressed families of the grievously ill that availing benefits under AB-PMJAY could take months.
Way Forward
- Several healthcare facilities have arogyamitras to counsel relatives of patients. But their role ends at registering claims.
- Empowering counsellors to handhold patients till their claims are settled will be of significant help.
- To make the scheme more expansive, the government should narrow the doctor-patient asymmetry.
- Ease of access and quality of care will be a crucial determinant in the health-seeking behaviour of senior citizens. Therefore, besides financial assurance, policymakers must ensure that there are enough healthcare centres and adequate facilities to take care of the needs of the elderly.
Editorial 2 : What Centre can learn from States
Context: How direct benefit transfer empowers women
Status of women in Economy
- India’s female labour force participation rate is just 28%.
- For every five men in managerial positions, only one is a woman.
- India ranked 127th out of 146 countries in the Global Gender Gap Index 2023.
- Three out of 10 women in the age group of 18-49 years have experienced violence from their spouses as per a survey by Niti Aayog.
Direct Benefit Transfer (DBT) for financial autonomy
- Much of the income that comes through DBT is spent by the woman at her own discretion.
- Targeting low-income households through DBT schemes is beneficial as these households allocate a larger proportion of their income to basic necessities like food and fuel.
- Bottom 20% of rural households spend 53% of their income on food and bottom 20% of urban households spend 49%. Therefore, much of the money provided through DBT circulates back into the economy.
DBT schemes in states
- Jagananna Amma Vodi (Andhra Pradesh), Mahalakshmi Scheme (Telangana), Gruha Lakshmi (Karnataka), Ladki Bahin (Maharashtra), Ladli Behan (Madhya Praddesh) Lakshmir Bhandar (West Bengal) etc.
- All these schemes are fully sponsored by the states.
- Cash incentives under Lakshmir Bhandar in Bengal have enhanced women’s ability to make financial decisions and improved their position within the family.
DBT schemes of Union Government
- There are 53 ministries under the Union government that run 315 DBT schemes, of these, 13 are related to the Ministry of Women and Child Development.
- Ministry of Women and Child Development has an abysmal track record in implementing the schemes and ranks 31 in the DBT Performance Rankings.
- There is no central scheme that directly transfers financial support universally to all women or specifically targets low-income women.
- Pradhan Mantri Matru Vandana Yojana gives financial support to pregnant and lactating mothers.
Conclusion
The IMF has called India’s DBT schemes a logistical marvel. A nation wide roll out of such scheme for women will help in bettering the statistics mentioned in opening of this analysis.