New health scheme flawed: IMA


Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: Ayushman Bharat Scheme

Mains level: The newscard highlights very important bottleneck in the implementation of the very ambitious health care initiative, which cannot be ruled out.


Limitations of Insurance Driven Healthcare

  1. The Indian Medical Association (IMA) has demanded a review of the Centre’s ambitious National Health Protection Scheme, saying it has “conceptual deficits and operational flaws”.
  2. It said current policy change in India will only end up strengthening the insurance business.
  3. In addition to non-creation of new public sector hospitals, the government will lose around ₹400 crore to private health insurance companies which will manage the scheme.

Issues highlighted by IMA

  1. The IMA demanded that the costing undertaken be transparent and be in public domain.
  2. The doctor’s body said the money allotted for the Ayushman Bharat — National Health Protection Scheme (AB-NHPS) would have better served the country if every district hospital is strengthened with an infrastructure of ₹2 crores each.
  3. The same money invested in our public hospitals would have brought secondary and tertiary care closer to poor in our government hospitals.
  4. The doctors body said the rates quoted by the government for various procedures are abysmal and impractical and most of them do not cover even 30% of the cost of the procedure.
  5. In the garb of cost-cutting, the government is exposing the people to danger in the hospitals.

Example: Caesarean sections underwritten for ₹9,000 cannot ensure the safety of the mother and the child

Key Suggestions

  1. IMA has suggested to the Union government that NHPS should be modeled as healthcare purchase directly from the provider hospitals removing the insurance companies and third-party administrators.
  2. These intermediaries siphon off 40% of the budgeted money and are breeders of corruption and unethical practices.
  3. The IMA said the way forward for the country is to invest in our government hospitals for better health infrastructure and manpower.


Indian Medical Association

  1. The IMA is a national voluntary organization of Doctors of Modern Scientific System of Medicine in India, which looks after the interest of doctors as well as the well being of the community at large.
  2. It was established in 1928 as the All India Medical Association, renamed “Indian Medical Association” in 1930 and is headquartered in New Delhi.
  3. It is a society registered under The Societies Act of India, 1860.
  4. It delegates its powers to a Working Committee (A representative body of all state Branches) for implementation of programmes and activities.
  5. The Indian Medical Association is a founder member of the World Medical Association.
Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.
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