Towards a Healthy India

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a national health insurance scheme by the Government of India, offering free healthcare coverage to low-income earners and a range of benefits. It covers a wide range of medical expenses, including medical examinations, treatment, and consultation; pre-hospitalisation up to three days; medicine and medical supplies; non-intensive and intensive care services; diagnostic and laboratory tests; medical implantation services; accommodation benefits; and food services. Unlike previous schemes, this one offers medical and allied services completely free.

More so, it comes with cashless access to healthcare services at empanelled public and private hospitals across India. Additionally, these benefits are portable across India, so beneficiaries can visit any empanelled hospital for cashless treatment, and there are no restrictions on family size, age, or gender. However, it was observed that over a quarter of those admitted under the scheme were senior citizens, many of whom still faced barriers due to income restrictions. Therefore, the union cabinet’s decision to remove income level conditions for Ayushman Bharat beneficiaries was a logical step to ensure broader access to healthcare, especially for the elderly.

While PM-JAY is a significant step toward addressing healthcare accessibility for low-income groups, the broader healthcare landscape in India remains a complex mix of progress and challenges. On one side, one would find glitzy steel and glass structures delivering high-tech medicare to the well-heeled, mostly urban Indian, while at the other end rests the ramshackle outposts in the remote reaches of the “other India,” trying desperately to live up to their identity as health sub-centres, waiting to be transformed into shrines of health and wellness. With the rapid population growth, diversity is likely to bring in even more complexity in the future. However, awareness, accessibility, affordability, and accountability have consistently been common challenges, while the availability of adequately trained manpower remains the primary hurdle in providing healthcare for all.

The glorious tradition of our public health dates back to the Indus Valley civilisation (5500–1300 BCE), where one finds mention of “Arogya” as reflecting “holistic well-being.” However, the five A’s mentioned earlier prevented us from attaining the goal of Aarogya for all. The enormity of the goal catering to almost a fifth of the global population—was also an obvious cause.

Awareness is the foremost challenge. Adequate knowledge regarding breastfeeding practice was found in only one-third of the antenatal mothers in two studies. Moving ahead in the lifecycle, a study in urban Haryana found that only 11.3% of the adolescent girls studied knew correctly about key reproductive health issues.

A review article on geriatric morbidity found that 20.3% of participants were aware of common causes of prevalent illness and their prevention. All these studies indicate a low level of health awareness in the Indian population. The remedy to this problem can be found in the recent success of Swach Bharat Abhiyan and the way the issue of open defecation was made an issue of the past. A similar time-bound approach and timely interventions at the school level would help resolve this problem.

There is hardly any diversity of opinions that other issues of accessible, affordable, and accountable health facilities would be resolved with the advancement of schemes like PMJAY. What remains is the issue of the availability of an adequately trained workforce. With the present government’s thrust on skills training and the rapid increase in the training facilities for medical and paramedical students across the country, the issue of the availability of workforce is expected to be resolved very soon.

While initiatives like PM-JAY are tackling domestic healthcare challenges, they also have broader implications. As India enhances its healthcare infrastructure and access for its citizens, it simultaneously establishes itself as a leading destination for medical tourism. Factors such as cost-effective treatments, advanced technology, a diverse range of specialities, alternative medicine options, English language proficiency, and ease of travel have all contributed to the growth of India’s medical tourism industry.

While India’s healthcare sector is evolving with initiatives like PM-JAY and the rise of medical tourism, the journey toward providing comprehensive, accessible, and affordable healthcare for all is far from over. Addressing the systemic challenges of manpower shortages, infrastructure gaps, and health awareness will be key to building a more equitable healthcare system. With continued investment and innovative solutions, India has the potential to transform not just as a leader in medical tourism but also as a country that ensures quality healthcare for all its citizens.