New Delhi, March 16 : The Congress on Saturday said the much publicised Ayushman Bharat scheme, also known as Modicare, was a “jumla” (hoax) as it excludes outpatient treatment, which constitutes 87 per cent of patients.
“The claim that ‘Modicare’ has provided each household insurance cover of Rs 5 lakh is a huge fraud. The cheapest equivalent private sector plan in the market for a family headed by a 30-year old costs Rs 5,252 per year,” Congress spokesman Jairam Ramesh said.
He said most plans are in the Rs 10,000-15,000 range, but Pradhan Mantri Jan Arogya Yojana (PMJAY) claims to provide the same for Rs 1,100, with a central contribution of Rs 660.
“In Chhattisgarh, the state government calculated that the Rs 1,100 premium is enough to cover only Rs 50,000 and made insurance firms bid for only Rs 50,000 insurance cover.
“All claims above Rs 50,000 and Rs 5 lakh are paid by the state insurance trust, the Mukhyamantri Sanjeevani Sahayata Kosh Yojana, to which the central government contributes no money,” Ramesh said.
“The state government calculates the actual cost of providing Rs 5 lakh cover as Rs 2,000 per year. The claim that ‘Modicare’ is giving Rs 5 lakh of insurance to the people is a ‘classic jumla’,” he said.
He said patients will not have access to adequate healthcare under PMJAY because it excludes outpatient treatment.
“Outpatient treatment is a serious financial burden that accounted for 63 per cent of the Rs 4,955 spent by households out of their pockets on health in 2014. The Modi government’s lack of focus on primary healthcare reflects in its spending priorities.
“Under the National Health Mission, 1.5 lakh primary health centres and sub-centres are to be upgraded into Health and Wellness Centres. But measly budget allocations of Rs 1,200 crore in 2018-19 and Rs 1,600 crore in 2019-20 show a lack of intent,” he said.