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Health insurance for 500 million Indians

Sharing experiences and lessons learned after one year of implementation

A happy orga team at the end of the event

One year after India launched the world’s largest government-funded health insurance scheme PM-JAY, its National Health Authority invited over 1400 delegates to discuss the scheme’s progress, achievements and learnings from implementation.  Prime Minister Narendra Modi and Health Minister Dr Harsh Vardhan joined the event entitled ‘Arogya Manthan’ or ‘Brainstorming for health’.

Have a look at the photo gallery which shows further pictures from the event (photographers: NHA, Susanne Ziegler).

Arogya Manthan took place on 30 September and 1 October in New Delhi and the whole spectrum of PM-JAY stakeholders - from high-ranking central and state government officials, representatives of development partner agencies and NGOs to hospital representatives and PM-JAY beneficiaries – were in attendance.

Following the official opening by Dr Harsh Vardhan, India’s Minister for health, Dr Indu Bhushan, CEO of the NHA, summarized what PM-JAY has achieved in its first year: With 32 states and Union Territories implementing the scheme beneficiaries can seek treatment in over 18.000 public and private hospitals across India. So far 5 million persons have made use of these provisions and hospital claims of over 900 million EUR have been processed.

Ms. Preeti Sudan, Secretary in India’s Ministry of Health and Family Welfare (MoHFW), gave on overview of lessons learnt from implementing RSBY (Rashtriya Swasthya Bima Yojana), PM-JAY’s predecessor scheme, India’s social health insurance scheme from 2008 until 2018. She showed how many of the insights generated in this period have informed the design and roll-out of the new scheme. 

Dr Vinod Paul, Member of the National Institution for Transforming India (NITI Aayog), underlined that PM-JAY is an important step forward on India’s journey towards Universal Health Coverage (UHC). He emphasised that the public and private sector need to continue working together in making a holistic healthcare system a reality. He highlighted the collaboration between the central and state governments in implementing PM-JAY as a prime example for India’s federal system. His vision for the future is that India’s healthcare system will provide a continuum of care to which every citizen has equal access. 


Research on health insurance can inform policy and practice

Dr Nishant Jain explains poster to high ranking Indian officials

In a series of plenary and parallel sessions government representatives shared PM-JAY-related learnings and best practices. 

As part of the session “Setting Research Agenda”, the Indo-German Social Security Programme (IGSSP), implemented by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) on behalf of Germany’s Federal Ministry for Economic Cooperation and Development (BMZ), presented the findings of several recent impact evaluations of the RSBY scheme, the predecessor scheme of PM-JAY. These findings inform the further development of PM-JAY whilst also serving as baseline for future research on health insurance in India. Dr Nishant Jain, Programme Director of IGSSP, reminded delegates of the importance of applied research, stating that ‘Researchers should do research which is actually useful for the government and for policy makers. According to Jain, the preconditions for a fruitful exchange between researchers and India’s policy-makers are promising: ‘The government is open to take suggestions on board. We have to utilise data in order to illuminate ourselves.’

As part of a poster exhibition at which various agencies presented findings of evaluations, GIZ showcased several posters, amongst them its analysis of the gender dimensions of RSBY, the predecessor scheme of PM-JAY. The analysis showed that women who were enrolled in RSBY were more likely to make decisions about their own and their family's health - a very welcome ‘side-effect' of their enrolment. Such evidence-based insights underscore the importance of applying a gender-sensitive and inclusive approach to the design and implementation of health insurance schemes.


Modi calls for a holistic approach to realise ‘Ayushman Bharat’, a Healthy India

India’s prime minister Narendra Modi attended the second day of the event. He made a point of listening to PM-JAY beneficiaries from across the country who were proud to share their healthcare experiences with him. 

After looking at an exhibition about PM-JAY’s first year he launched a mobile application for PM-JAY-user and then released a commemorative stamp celebrating one year of PM-JAY implementation.

In his address to the attendees Modi thanked the Indian states and Union Territories for their commitment and determination to implement the scheme. Without the close coordination between central and state governments, the implementation of a nation-wide health insurance would not be possible.

India’s health system is undergoing rapid changes. The reform Ayushman Bharat (Healthy India) has the potential to become one of the most far reaching reforms of India’s health care system to date. According to Modi, ‘access to medical facilities should be available to every poor person and every citizen of the country.’ He said that ‘Ayushman Bharat plays an important role in saving the lives of ordinary people but is also a symbol of the dedication and strength of the India’s 1,3 billion people.’

Ayushman Bharat consists of two pillars: the PM-JAY insurance scheme and the setting-up of 150.000 primary healthcare centres, so-called Health and Wellness Centres. In combination, they aim at improving access to public and private health care services and at reducing out-of-pocket payments. PM-JAY now covers around 500 million persons which makes it the world’s largest completely government funded health insurance scheme. Every family registered with PM-JAY has an annual budget of the equivalent of 6,200 EUR available for inpatient health services. 

The Indo-German Social Security Programme is PM-JAY’s trusted partner

While PM-JAY constitutes a paradigm shift and changes the way healthcare is delivered in India, it did not start from scratch. In many ways it builds upon the processes, financing mechanisms and IT architecture of its predecessor scheme RSBY. The Indo-German Social Security Programme (IGSSP) was one of the Indian government’s main advisors on the design and implementation of RSBY. As a trusted partner on health insurance issues, it continues to provide technical advice for PM-JAY and supported the organisation of this important event.

Further information

For more information, write to Nishant Jain, email nishant.jain@giz.de.

Susanne Ziegler, October 2019

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