Ayushman Bharat: Success & Failures of India’s Healthcare Schemes | Dhruv Rathee
Friends last year in 2017, 55% of people fell below the poverty line in our country just due to one reason. and that one reason is healthcare spending. people didn’t had enough money to spend on their healthcare. 38 million people out of 55 million went below the poverty line just because they didn’t had money to buy medicines. they didn’t had money to buy essential medicines. This had been found by a research done by Public health foundation in June 2018. The actual poverty line has been considered in this research which is 1000rs per month in urban and 816rs per month in rural areas. So you can imagine the bad condition where people even dropped further than this poverty line only just for buying medicines. Namaskar Friends, today I would like to teach you about the healthcare and medicines. whys is it one of the most important factor whenever we talk about the country’s growth? What are the existing government schemes and their results and in the end I will tell you what can you do to improve the healthcare system in the country. come let’s see. Friends this story is of a family living in Orissa. Like them there are lakhs and crores of families who goes through such situation in our country. 75% of rural household in our country earns 5000rs or less than that per month. So looking at this you can see how easy it is for the poor people to slip in the poverty line just due to the health care expenditure. A 2014 survey from National survey office revealed that medicine is the biggest contributor of the healthcare expenditure. 72% of healthcare expenditure from the rural households goes towards medicines. and 68% healthcare expenditure from the urban households goes towards medicines. Our central government and state government has released many schemes related to healthcare and to make medicines affordable. some of them were successful and most of them were unsuccessful in their implementation. The biggest nationwide scheme out of these is Pradhan Mantri JanAushadi Yogna The objective of this scheme is making quality medicine available at affordable prices prices for all through exclusive outlets, Janaushadi Kendras. so as to reduce out of pocket expenses in healthcare. This scheme was made as a solution for exactly the same problem which I explained you in this video. To minimise the expenses of medicines which are out of pocket expenses for the poor people. This scheme was launched on 22 December 2014 and till date friends there are more than 3700 Jan aushadi Kendras which provides more than 700 medicines to people at cheap and affordable price. If you don’t know friends that there are two types of medicines. One is generic and the other is the brand name. Brand name is a medicine which is manufactured by a company and that company owns the patent for that. So the brand name medicines are sold very expensive. Generic medicines are like brand name but they are made by different companies and generic medicines are sold at the government stores. Quality of both the medicines are same but generic medicines are relatively cheaper. Here you can see how cheaper are these generic medicines available at the jan aushadi kendra as compared to the brand medicines available at the private pharmacies. So the intention is wonderful of this scheme but the implementation is where there’s a lot of failure. At many Jan aushadi kendras it is reported that many brand medicines are being sold at a very high place, fooling people. It is even told in many reports that the quality control of the medicine is not done properly The print reports that the agency which looks after the quality control has no one in their department for the quality control. When state government agencies did a quality control of Jan aushadi kendras medicines that time it was known that many medicines failed that quality control tests! Mahashtra state government couldn’t take out the tenders for jan aushadi Kendras for 2 years because the politicians there were encouraging their own NGOs. and the biggest problem here is that there’s not enough supply of the medicines. The supply of the medicines are not happening in the correct way. In some stores there’s just 40-50% of medicines available Some news report shows that Jan awshadi Kendra have failed completely at states like Jharkhand and Madhya Pradesh due to very big problem of supply. Now the thing is what can you do here friends to improve this situation in our country? You can do alot! First of all… here I’ve mentioned a link of the website, here you can go and check the jan aushadi kendra present near you. This you can go and tell all your poor and helpless people who can’t afford to buy medicines on their own. who can’t afford a quality healthcare themselves, tell them that there are such Jan aushadi kendra where less expensive medicines are available and guide them about its working. After that the second thing you can do is to go yourself at one of the Jan aushadi kendra and check whether all the medicines are available properly there or not and if not then you can complain at this number and at this email Id. Third thing you can do is that go to the MLA, MP or the head of Municipality of your areas local and tell them that you need to open a Jan Aushadi Kendra at your area. If no one has started in your area or if it’s less in number. This will be more effective if you go before the election time. and it will be even more effective if you take many people along with you. and all of you say the same that you need to open a Jan aushadi kendra in your area. Fourth thing you can do is whenever you go to your doctor tell him to prescribe only generic medicines and not the branded medicines whenever the option is available. Fifth thing you can do is to pressurise our Government to make healthcare a priority. The problems and failures that are happening in the Jan aushadi Kendra is due to the implementation problem of Government. It’s their systematic failure so here it’s very important to pressurise the government There’s a petition related to this which I would suggest you to sign. The link of this petition I’ve added in the description and also in the top comment. It’s a very simple demand of Right to medicine! There’s should be a right to essential medicines for the people at an affordable price. So there would be a big impact I feel if you do all these 5 things friends. Especially in the lives of those lakhs and crores of people who are below the poverty line due to unable to buy medicines Few days ago, a very ambitious schemes has been launched friends related to healthcare by our government. called as Ayushman Bharat. It is popularly known as ModiCare. It’s a wonderful scheme which a very good intention. This gives a way for health insurance to 50 crores of poor people in our country. A promise of 5 lakh rupees, per year, per family is made to provide insurance. So the intentions are very good but the things to look will be the implementation of this scheme. Will the benefits of this scheme reach the people actually? only the time will say this. Come now let’s look at such examples which have been successful in providing affordable medicines to people by different state governments. so that our central government can learn something and apply it in it’s own schemes. The very first example is of Tamil Nadu. An independent organisation was made away from the government in Tamil Nadu called as Tamil Nadu Medical Service Corporation. It’s work is to procure all the medicines that are going to be sold in the entire state. To buy medicines from the companies and sell in the state at an affordable rate. Now since this is just an organisation, it had a centralised tendering process. due to which it could buy medicine at a very cheaper rate and sell people too. Logistic as well the infrastructure was good, a very good commitment from the administration and political will was also there. so because of all these reasons this healthcare scheme from Tamil Nadu is one of the best scheme in the country. This organisation received Rajiv Gandhi’s national quality award in 1996 and even world bank appreciated it’s performance in 2004 Next example is very recent and very popular of Delhi’s Mohalla Clinics. At Mohalla Clinics you will not only get more than 100 medicines free of cost but also more than 200 free health check ups, tests and diagnostics. so this has even reached a step higher of affordable medicines. as of now there are more than 200 mohalla clinic in Delhi and it is expected that by next year more than 1000 Mohalla clinics will be established. More than 1000 clinics means that almost everyone in Delhi will be able to reach a Mohalla clinic in it’s 5km radius. This has become so successful that it has received appreciations from International Organisations and many NGOs too. Next example is of Telangana Government, who got inspired from Mohalla clinic to open Basti clinics. They started this project in Hyderabad city where they have opened 17 such clinics so far. where again medicines are free of cost and many health check ups and diagnostic tests are for free. They have started this project this year only but it’s success story can be heard already. Next example is of Kerala and the government there has thought of something different than Delhi’s Mohalla Clinic. They decided to improve the service quality and infrastructure of the existing healthcare facilities rather than making the new ones. So they chose 703 primary healthcare centers from the state and they are improving the service and infrastructure of those. The last example of successful schemes I would like to give would be of Rajasthan. Rajasthan’s government was quite inspired by Tamil Nadu’s model Like Tamil Nadu they made new independent organisation, Rajasthan Medical services corporation. It’s aim was to provide people essential medicines at affordable rates. They started a new scheme as well, Chief Minister’s Free drug distributions. and study by WHO and Public health organisation, India shows that this scheme was very successful even. 70-80% of medicine supply had been there in their clinics and in their healthcare centers. so these are few examples of successful government schemes friends. Rest of the state Governments should take inspirations from this and our central Government too should take inspiration from this that how correct implementations of scheme is done. Remember the 5 actions that I have told in the video and don’t forget to sign the petition. I’ve shared the link in the top comment. I hope that you will get a lot of new things to learn from this video. If you like my work then you can donate on patreon.com/DhruvRathee, so that I can keep making such informative videos for you. Okay, let’s meet in the next video. Thank you.