In govt’s health scheme, most for cataract surgery and root canal

In govt health scheme

The Pradhan Mantri Jan Arogya Yojana (PMJAY), established as protection against large expenses arising out of serious illnesses, has seen the most claims for relatively minor procedures like cataract surgery and root canal treatment, available data from several states for the first two months of the scheme shown.

The data, from Greenfield states, also reveal a high incidence of claims for enteric fever or typhoid. The survey is yet to be fully integrated, and the final picture could, therefore, be somewhat different.

Greenfield regions are those that had no health insurance scheme before PMJAY. They comprise of some of India’s poorest and most populous states, including Uttar Pradesh, Bihar, and Madhya Pradesh, apart from Chhattisgarh, Himachal Pradesh, Haryana, Jharkhand, Uttarakhand, Jammu & Kashmir, and all of the Northeast.

Between September 23, when the scheme was officially established, and November 24, 6,900 claims were made for cataract surgery, and 4,900 for root canal treatment, official data show. A total 3,400 claims were made for the typhoid package during this period.

PMJAY is the tertiary care arm of the government’s flagship Ayushman Bharat scheme, under which 10.74 crore families will be given an annual health cover of Rs 5 lakh. The other part of the scheme is the establishing up of 1,53,000 health and wellness centers, the first of which was inaugurated in April in Bijapur in Chhattisgarh.

All states leaving Telangana, Odisha, and Delhi have signed the Memorandum of Understanding with the newly created National Health Agency (NHA), the implementing authority for the PMJAY. Rajasthan has signed the MoU but is yet to launch the scheme.

The PMJAY, billed as the most ambitious health scheme in the world, is one of Prime Minister Narendra Modi’s flagship social welfare initiatives. The NHA has been filing a report of its progress to the Prime Minister’s Office at 5 pm every day since the launch of the scheme, comprising on weekends, holidays, and festival days. The daily report includes updates on the numbers of health cards issued, beneficiaries admitted, and claims raised, and even the numbers of calls answered and letters dispatched to beneficiaries. The health scheme has made an occasional appearance in Modi’s campaign speeches in the ongoing Assembly elections.

The process of automatic integration of data from the states is not accomplished yet. Once that is done, the PMJAY dashboard will be made public.

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