Only 13 per cent of hospitalized patients got PM-JAY: Analysis

Only 6.05 lakh people out of 50 crore eligible people covered under Pradhan Mantri Jan Arogya Yojana, availed the benefit of the Ayushamn Bharat health insurance scheme for COVID-19 until June 30, 2021.

This means, out of an estimated 45,50,000 people who were hospitalized for COVID treatment in public or private hospitals, only 13 percent got the insurance, indicating poor execution of the program by the government.

Though there is no official data available on statewide hospitalization of COVID-19 patients, based on mathematical modelling, data available in some state COVID dashboards and media reports, the analysis concluded that on average 15 per cent of the COVID-19 patients were isolated in hospitals.

38 per cent of the people (17.3 lakh) self-financed or borrowed their way through, while 49 per cent (22.2 lakh) relied on other health insurance schemes. Andhra Pradesh and Karnataka were the best states when it came to effective implementation of PM-JAY, as per an analysis by Jeevan Raksha, an initiative of Proxima Consulting.

"There is no trace of PM-JAY scheme in some states such as Punjab and Gujarat, where not even a single person reaped the benefit of the scheme. In Assam (619), Bihar (19), and Uttar Pradesh (875) collectively only 1513 PM-JAY beneficiaries have got treatment for COVID 19. There was no trace of effective implementation in North-Eastern state and union territories," the analysis read.

"80 per cent of the PM-JAY beneficiaries were from Andhra Pradesh, Karnataka and Maharashtra. Karnataka and Andhra Pradesh added additional families into the PM-JAY scheme beyond those families who are part of the Socio-Economic Caste Census (SECC). In both the states, 38 per cent and 55 per cent of the patients were covered by government insurance. This demonstrates effective implementation. However, the majority of people in other state and union territories faced the brunt and spent from their own pocket," Mysore Sanjeev, convenor, Jeevan Raksha.

In Maharashtra, 18 per cent of the hospitalizations were covered by the scheme. As per the analysis, in North-Eastern states, around 43,000 people could have been hospitalized for treatment but only around 2000 people got PM-JAY cover, while in Tamil Nadu, which is among the states severely affected by COVID-19, 3.71 lakh people could have been hospitalized but only 10,377 got this insurance.

Although Gujarat, Tamil Nadu, Uttar Pradesh and Bihar have covered 43.8 lakh, 74.9 lakh, 1.16 crore, 1.08 crore families under Ayushman Bharat on paper, the number of people who received the insurance, in reality, was 0, 10,377, 875 and 19 respectively. Jammu and Kashmir, Himachal Pradesh and Haryana also saw a poor impact of the scheme.