Engagement of the private sector in the Pradhan Mantri Jan Arogya Yojana: Examining the promise of a watershed moment for Universal Health Coverage

Engagement of the private sector in the Pradhan Mantri Jan Arogya Yojana: Examining the promise of a watershed moment for Universal Health Coverage by  Susrita Neogi

Abstract:
The aim of Universal Health Coverage (UHC) has been reiterated in multiple Indian policy documents in the past. Many states as well as central governments have also espoused this goal through government-funded health insurance schemes. The recently launched Pradhan Mantri Jan Arogya Yojana (PMJAY) is yet another insurance scheme of the federal government to provide secondary and tertiary care services to poor and vulnerable sections to achieve UHC. By design, the insurance model of financing health care opens a window to engage with private healthcare providers. However, as past experiences suggest, engaging the private sector in pursuit of public health goals has not been an optimally effective strategy, either in India or globally. This can be explained ideologically through critiques of strategic purchasing as well as pragmatically through the gaps in the implementation of the previous schemes due to the weak stewardship role of the government. This paper compares the design of PMJAY with earlier public insurance schemes and suggests the scope for improvement in the new scheme to successfully achieve the goal of UHC. (Read Full Paper)