Good, but not enough
Extension of free health coverage to all over 70 years is good, but more needs to be doneIn a welcome move, the Union government’s decision to extend the coverage of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to senior citizens over 70 years, irrespective of their income, provides a modicum of free health coverage to nearly 60 million people. With out-of-pocket expenditure for health care in India among the highest in the world, the decision is indeed laudable. While the decision to provide free health coverage up to ₹0.5 million per year for a section of the population is noble, it will in no way fulfil the public health objectives that are much needed for the targeted beneficiaries. First and foremost, the health assurance scheme is limited to secondary and tertiary care hospitalisation. The absence of coverage for outpatient care, diagnostics and medicines is particularly concerning as chronic diseases have increased sharply in India in the last few decades. Increased life expectancy and an early onset of these diseases would mean that people over 70 may very often suffer from multiple chronic diseases. Most of the health-care expenditure by the elderly will, therefore, be through outpatient care (40%-80%), which will not be covered by the scheme. Since its launch in 2018, the penetration of PM-JAY into smaller cities and towns has been low in most States. Unlike in most of the southern States, primary and secondary health care in the public sector has been largely neglected and is inadequate and ill equipped to meet the demand in other parts. Robust primary and secondary public health care will sharply cut the load on tertiary health care and hence the need for curative care; a reduced curative care load at tertiary hospitals will make the PM-JAY scheme succeed.Thailand focused and progressively strengthened its primary health-care system, and even diverted funds earmarked for urban hospitals to build rural hospitals and health centres to attain universal health coverage. In contrast, in the U.S., banking primarily on insurance-based schemes is what led to the surging costs of health care. India appears to be going the U.S. way. Though there is waning enthusiasm in the private sector due to low treatment rates and delayed payment, as per media reports, since its launch, two-thirds of the total money spent each year under the PM-JAY scheme went to private hospitals; it was 53% in the case of the southern States. Weakened primary and secondary health care will result in an overload in tertiary health care, which the private players will be well poised to take advantage of. This can lead to a further shrinking of the government’s commitment to strengthen the public health-care system by over-relying on the insurance modality which is neither affordable nor will provide appropriate health care for the needy. In its present form, PM-JAY is a measure that is essential, but is incomplete
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Irrespective of (phrase) – regardless of, despite, notwithstanding, no matter
के बावजूद
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Modicum (noun) – Small amount, bit, fragment, dash
थोड़ा सा
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Out-of-pocket (adjective) – Direct payment, personal expense
व्यक्तिगत खर्च
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Indeed (adverb) – actually, certainly, really, in fact, truly
वास्तव में
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Laudable (adjective) – praiseworthy, commendable, admirable, meritorious, deserving praise
सराहनीय
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Noble (adjective) – Honorable, virtuous, worthy, respectable
उत्कृष्ट
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Beneficiary (noun) – Recipient, receiver
लाभार्थी
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First and foremost (phrase) – Most importantly, primarily, chiefly, above all
सबसे पहले
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Secondary care (noun) – Specialist care, treatment in a hospital after referral from primary care
माध्यमिक चिकित्सा सेवा
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Tertiary care (noun) – Advanced medical treatment, specialized care, high-level care
तृतीयक चिकित्सा सेवा
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Outpatient care (noun) – Ambulatory care, treatment without admission to a hospital
बाह्य रोगी देखभाल
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Diagnostic (noun) – Tool for diagnosis, diagnostic method, analysis, assessment
निदान
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Concerning (adjective) – Worrying, Troubling, Disturbing, Bothering, Upsetting
चिंताजनक
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Decade (noun) – A period of 10 years
दशक
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Chronic (adjective) – Persistent, long-lasting, constant, continuing, lingering
दीर्घकालीन
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Onset (noun) – Beginning, start, commencement
प्रारंभ
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Often (adverb) – frequently, in many instances, repeatedly, again and again
अक्सर
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Penetration (noun) – The extent to which a product is recognized and bought by customers in a market.
प्रवेश
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Unlike (preposition) – Different from, dissimilar to, not like, unalike, contrasting with
के विपरीत
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Neglect (verb) – Ignore, overlook, disregard, omit, forget
उपेक्षा करना
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Ill-equipped (adjective) – Poorly prepared, inadequately supplied, unprepared
अप्रशिक्षित
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Meet (verb) – fulfil, achieve, accomplish
पूरा करना
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Robust (adjective) – strong, vigorous, sturdy,
मजबूत
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Curative care (noun) – Healing treatment, therapeutic care, remedial treatment
उपचारात्मक देखभाल
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Strengthen (verb) – reinforce, enhance, increase, make stronger, buttress
मज़बूत बनाना
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Divert (verb) – Redirect, reallocate, shift, reroute
स्थानांतरित करना
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Earmark (verb) – Designate, allocate, set aside, reserve
निर्धारित करना
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Attain (verb) – Achieve, reach, gain, obtain, secure
प्राप्त करना
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In contrast (phrase) – used when second thing very different from first. इसके विपरीत
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Lead (to) (verb) – Result in, cause, bring about, give rise to, provoke
कारण बनना
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Surging (adjective) – Increasing rapidly, rising, swelling, growing
बढ़ता हुआ
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Waning (adjective) – Decreasing, diminishing, reducing, declining, fading
घटता हुआ
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Enthusiasm (noun) – Eagerness, keenness, fervor, zeal
उत्साह
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Result in (phrasal verb) – Cause, bring about, produce, lead to
का कारण बनना
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Poise (to) (verb) – Balance, stabilize, brace, prepare, ready
तैयार होना
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Commitment (noun) – Dedication, promise, obligation, resolve
प्रतिबद्धता
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Modality (noun) – Method, system, approach, technique
प्रक्रिया
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Essential (adjective) – Vital, indispensable, important, crucial, critical, necessary
आवश्यक