KOCHI: Kerala will eventually join Ayushman Bharat, the Narendra Modi Government’s flagship health initiative, but on its own terms, it has emerged.
“We have never said we will not join Ayushman Bharat. The terms of engagement are still being negotiated,” said Rajeev Sadanandan, Additional Chief Secretary, Health & Family Welfare. However, this year the state will not get significantly more funds from the Centre than what is due under the Rashtriya Swasthiya Bima Yojana (RSBY) scheme, he said.
Union Home Minister Rajnath Singh, who was here last week, had asked the state government to “keep politics aside and join Ayushman Bharat to ensure the scheme’s benefits reach the poor and needy in the state”.
The state government authorities said though PM Modi has been projecting the Ayushman Bharat scheme as a big-ticket Central scheme, in reality the overwhelming share of the scheme’s expense is borne by the states. “The way it is structured now, 80 per cent of the expense has to be borne by the state. This is a state scheme,” said Sadanandan.
Another senior officer explained the diseases in Kerala are different, the consumption pattern varies, and hence the state cannot be clubbed with the other states under the so-called universal health scheme. “If some Under Secretary-rank officers in New Delhi decide our fate, we will be in trouble,” he said.
Since the state bears 80 per cent of the scheme’s expenses, the Kerala Government wants the flexibility to change the structure of the scheme in a way it suits the state’s healthcare needs. Parallely, the government is also planning to merge its various healthcare schemes, including the now near-defunct Karunya Benevolent Fund, Cancer Suraksha Scheme and Comprehensive Health Insurance Scheme, said Sadanandan.
In terms of delivery mechanism, Kerala is far efficient than the other states, a point underscored by Finance Minister T M Thomas Isaac recently. In RSBY, for instance, the total claims so far is Rs 120 lakh, of which Kerala accounts for Rs 53 lakh. “Kerala with a population share of 3 per cent accounts for 42 per cent of the claims - a sad commentary on implementation. Ayushman Bharat also is on the same track,” Isaac had tweeted recently.
“The argument that larger the number of beneficiaries lower will be the premium is irrelevant. Each state is going to independently tender for beneficiaries as per the Central norms, just as in RSBY,” Isaac said.
M I Junaid Rahman, president of Indian Medical Association, Kochi chapter on Sunday, felt the Centre’s scheme was good for the people as the sum assured will increase from Rs 30,000 to Rs 5 lakh.
Sadanandan said Kerala will eventually join the scheme after the state’s terms are agreed upon. “We need flexibility and once we get it, we will implement the scheme,” he said, adding, Kerala will receive `120 crore for the scheme and it would not want to lose it, given the financial constraints it is going through in the post-flood scenario.