Even as the Modi government’s ambitious flagship programme healthcare scheme, National Health Protection Scheme (NHPS), is likely to be launched on Oct 2, the government is determined to ensure that costs should not be a barrier in providing efficient healthcare services to over 10 crore people under Aushman Bharta,
The premium costs for insuring over10 crore people have not been fixed as yet and government remains flexible in finalising the premiums, said, Vinod Paul, Member, NITI Aayog,while addressing a gathering on ‘Implementation of NHPS & Ayushman Bharat'' organised by the Confederation of Indian Industry(CII) in Mumabi on Saturday.
“We want all the participating players including insurers, hospitals and other health care providers to have moderate amount of profit but not brutal profiteering at the cost of state exchequer.I think, for this mission to be successful, it has to be viable business and the intent is that we should have package rates and costing which is fair for the health sector as a whole and it is fair to the national exchequer as well,’’ Paul added.
To accomplish the objective of proposed NHPS and Ayushman Bharat, NITI Aayog is in consultation with various stakeholders. The hospitals are the integral part of delivering services under NHPS and the services will be offered through both Public and Private Hospitals across the country.NITI Aayog intends to undertake consultation with the hospitals with focus on the parameters like packages, empanelment criterion, fraud detection and control etc, explained Paul..
“We will provide all the details including the rates for specific healthcare facilities to the state governments which will manage the bidding among the insurers.The pricing which may vary from state to state will be fixed at the time of bidding,'' he said.
To control costs, the payments for treatment will be done on package rate (to be defined by the Government in advance) basis. The package rates will include all the costs associated with treatment. For beneficiaries, it will be a cashless, paper less transaction. Keeping in view the State specific requirements, States/ UTs will have the flexibility to modify these rates within a limited bandwidth, revealed Paul..
“We are trying to set up a robust fraud detection system to check leakages and also a grievance cell to redress the complains of the beneficiaries,'' he informed.
For settlement of claims, he said if the patient is from the same state it will done in 15 days and if the patient is from an outside state, it will done in 30 days.Even Niti Aayog will help setting up of hospitals and other healthcare facilities in tier II and tier III cities so that NHPS and Ayushman Bharat, can be implemented,
“We are finding all the means to reach out to people in the remote areas. At the primary health level big push to go to the people level, closer to people. In fact starting from Apr 3o- -every 30th of a month will be observed as an Ayushman day- there will be massive public contact programmes at the village level not only to create awareness but updating the list of beneficiaries. We are reaching trough Gram Sabhas to inform them their entitlements, creating helplines,'' he said.
Besides,PM Narendra Modi is going to write a letter to each of the beneficiaries of NHPS who are on the list of Socio Economic and Caste Census (SECC). .
Except Karnatak and Telengana , rest of states have indicated that they would be a part of Aushman Bharat, said, Paul.
Indian needs a comprehensive health care system as the diseases like cancer,hypertension,mental and old age problems are growing in the country..
“To day, we have 30 per cent of people suffering from hypertension while 10 per cent are diabetic. We haven’t done enough to tackle this We are creating a healthcare system where 2/3rd of health issues including prevention are managed at the primary health care.level,’’ he said.
The NHPS is designed to prevent catastrophic health expenditures. According to government data, in-patient hospitalisation expenditure in India increased nearly 300 per cent in the last ten years. More than 80 per cent of the expenditure is out of pocket (OOP). Out of pocket (OOP) expenditure in India is over 60 per cent which leads to nearly 6 million families falling into poverty due to health expenditures, explained Paul
Budget 2018-19 announced 'Ayushman Bharat" programme which aims to address health holistically – Health & wellness centres for comprehensive primary care including prevention and hearth promotion and a flagship scheme NHPS for secondary and tertiary care system.