AB will create a new health ecosystem | Rajiv Nath

Ayushman Bharat –  Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) will prove to be a game changer in Indian society and the progressive PMRSSM (Pradhan Mantri Rashtriya Swasthya Suraksha Mission) will ensure cost effective affordable universal healthcare system.

AB – the world’s largest government sponsored healthcare insurance scheme that aims to provide 10 crore of India’s poorest families with health insurance of `5 lakh each per year for secondary and tertiary care hospitalisation, will help to create a new ‘Health Ecosystem’ of universal healthcare for masses. It will also create an opportunity for domestic medical industry to improve efficiency and innovation to provide latest technology and quality products. If utilised properly, this would translate into a blessing in disguise for much coveted but barely moving Make in India initiative for the medical devices industry.

We see significant growth opportunities for the medical devices industry once AB is formally launched on September 25 and are ready to partner with the government in providing the latest technology and best quality affordable products.

For the world’s largest democracy of 1.3 billion, where over 65 per cent of the population has no significant insurance coverage and has been spending out of pocket for medical care, this social welfare scheme will spell widespread transformation in delivery of quality affordable healthcare in the country. I believe that it will help in making India take its place among the most progressive nations.

Our country is at a cusp of realising sustainable higher economic growth and reap the  benefits of demographic dividend. It needs a decisive push and quality affordable healthcare is one such factor which can put India in a higher growth trajectory by ensuring healthy labour force and increased efficiency.

I feel extremely aggrieved when I see that India is ranked 145 among 190 nations, lower than even Bangladesh, Sudan and Equatorial Guinea by the 2018 Global Healthcare Access and Quality Index. Its time that we change this landscape completely and I believe that AB will help in doing so.

It will help in redefining the healthcare delivery and products with low-cost hospitals, speciality clinics, medical devices costing significantly lower than imported devices, mobile technologies, which address primary healthcare needs and quality healthcare which is affordable.

It will take time for the entire system to evolve. There is a need to adopt ‘Reform To Transform’ approach to overhaul existing healthcare system and creating a new set up.

Our suggestions to the government are:

Importance to patient safety

Focus should also be on universal precautions for patient safety of medical devices such as injections which are widely used and are a major cause of blood borne infections (BBIs) in the country. The government should simultaneously launch ‘Swacch Injection Mission’ to ensure infection prevention in health care procedures.

In India, transmission of BBIs in unsafe healthcare is endemic. According to Indian Programme Evaluation Network Study, 3 to 6 billion injections are administered annually in India. About 60 per cent of these injection are found to be unsafe and 1/3 being reused. Further, poor hygiene in hospitals acts as an amplifier for infections. On a more serious note, we are actually waiting for a catastrophe to happen.

AB, a pan India programme, is a good opportunity for promoting injection safety and hygiene in healthcare procedures. To begin with, the government should make it mandatory to use only auto disable (AD) syringes in the medical treatment. Later on, more advanced safety engineered devices can be used.

Here, it is important to note that we are asking to use domestically manufactured AD syringes. So, this will also give a push to domestic medical devices industry and help in actualising ‘Make in India’  mission.

Promote buy Indian policy

It will be good if Indian healthcare system for AB has a ‘Buy Indian Preferential/ Price Market Access Policy’  for Made in India medical devices with minimal 50 per cent or higher domestic content and substantial transformation done in India to boost domestic manufacturing.

For medical devices, we need to promote culture of quality and safety and not lowest price, lowest quality as is the case of L1 bidding in government procurement. We believe human life is worth all the efforts to provide quality and safety.

Quality assurance

Ensuring quality in healthcare system will be paramount for success of this flagship mission. We suggest granting additional five per cent price benefit for ICMED Certification and two per cent IS:13485  Certificate supplier to reward quality compliant companies in government procurement. This mission will provide a great impetus for both the government and private healthcare industry to work together towards achieving the nation’s goal of providing universal healthcare. Striking the right balance between rewarding innovation in medical science research and catering to the needs of a nation’s healthcare system would be the key to success of this ambitious mission.