NEW DELHI: The Narendra Modi government’s flagship health insurance scheme — Pradhan Mantri Jan Aarogya Yojana — may have failed to help a majority of its beneficiaries during the worst of the Covid pandemic, when most of the people were struggling for access to healthcare, an independent analysis has shown.
The analysis carried out by Jeevan Raksha, a public-private partnership initiative, has found that only 5,85,750 of a total of 107,05,251 in 17 states — or just about 5% of the total hospitalisations were for Covid treatment between January 2020 and June 2021. PMJAY launched in September 2018 assures free hospitalisation coverage of upto Rs 5 lakh to nearly 60 crore poor Indians.
The latest report, however, showed that shockingly in Gujarat and Punjab, with 14.7 lakh and 6 lakh beneficiaries, respectively, not a single hospitalisation was for Covid treatment. In contrast, Maharashtra fared the best among states and every two of three patients who got the hospitalisation benefit under the scheme in the state, got treated for Covid-19.
The data has been analysed by the project, a partnership between management firm Proxima and the Public Health Foundation of India, from 17 major states that include the eight empowered action groups or socio-economically backward states. “The data clearly indicates the current status of PMJAY implementation as well as quality and integrity of some of the disclosed data,” said the report.
R S Sharma, CEO of National Health Authority which implements the PMJAY, was not available for comment despite attempts to reach him. The analysis, done meticulously with state-level data, pointed out that during January 2020 and June, 2021 over 3 crore Covid patients were traced and treated, while 4 lakh people succumbed.
During the same period, over 1.7 crore PMJAY beneficiaries availed treatment under the scheme but “surprisingly”, over 95% were reported as non-Covid treatment, it said, adding that only 5.85 lakh hospital authorisation were reported as Covid treatment.
Among backward states, 27 lakh beneficiaries have been authorised for treatment under PMJAY, but only 61,500 were treated for the disease. “This means during the Covid period, when people were struggling to get hospital beds for Covid treatment, 98% of the hospitalisations under the PMJAY Scheme was for treating non-Covid patients,” the analysis has said. The story was similar in Bihar, UP and Jharkhand.