Steps Taken to Reduce Out-of-Pocket Expenditure on Healthcare by Households

Key Highlights:

• The Government is implementing measures to reduce Out-of-Pocket Expenditure (OOPE) on healthcare through expanded access, infrastructure strengthening, and financial protection.
• Key schemes include National Health Mission (NHM), Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), Pradhan Mantri- Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), and Pradhan Mantri Swasthya Suraksha Yojana (PMSSY).
• Over 1.87 lakh Ayushman Arogya Mandir (AAM) have been operationalized to deliver comprehensive primary healthcare services.
• National Free Drugs Service Initiative and Free Diagnostics Service Initiative aim to reduce OOPE at public health facilities.
• AB PM-JAY provides a health cover of ₹5 lakhs per family per year for secondary and tertiary care to over 12 crore families.
• AB PM-JAY has been expanded to cover 6 crore senior citizens (70 years and above) with Vay Vandana Card.

Detailed Insights:

• The Ministry of Health and Family Welfare (MoHFW) supports States and UTs through various Centrally Sponsored and Central Sector Schemes.
• NHM assists State Governments in providing accessible and affordable healthcare towards universal health coverage.
• Ayushman Arogya Mandir offers a wide range of services including preventive, promotive, curative, palliative, and rehabilitative care.
• Financial support is provided to States/UTs for essential drugs at different levels of public health facilities.
• Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) makes quality generic medicines available at affordable prices.
• Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy stores are set up in some hospitals/institutions.
• AB PM-JAY targets the economically vulnerable bottom 40% of India’s population.
• States/UTs implementing AB PM-JAY can expand the beneficiary base at their own cost.

Key Concepts Involved:

• Out-of-Pocket Expenditure (OOPE): Direct payments made by individuals for healthcare services at the point of use.
• Centrally Sponsored Schemes: Schemes funded jointly by the central and state governments, with the central government contributing a major share.
• Central Sector Schemes: Schemes fully funded by the central government and implemented by central government agencies.
• Universal Health Coverage: Ensuring all people have access to quality health services without suffering financial hardship.