PM Jay: A Revolutionary Step in the Health Sector

As an aspirant for the UPSC Prelims , it's essential to be well-versed with all facets of this landmark scheme. Here are some key features of the PM Jan Arogya Yojana:

1. The scheme provides an insurance cover of Rs. 5 lakh per annum for each eligible family.
2. It does not impose any cap on family size and age, ensuring maximum benefit.
3. The scheme covers all secondary and tertiary care expenses incurred during treatment.
4. Pre and post-hospitalization expenses for 3 and 15 days respectively are covered, including all pre-existing health conditions. Post-hospitalization components include medicines and diagnostic tests.

The treatment components covered under this scheme, which you can expect in your IAS exam paper, include the following:

• Medical consultation, examinations, and treatment
• Medicines
• Intensive and non-intensive care services
• Medical implants
• Lab and diagnostic tests
• Accommodation and food services
• A defined transport allowance for patients
• Cashless treatment from any empanelled hospital (includes both public and private hospitals that implement the scheme)

Eligibility Criteria for PM Jan Arogya Yojana

For your UPSC exam preparation, it's important to note that the Pradhan Mantri Jan Arogya Yojana is an entitlement-based scheme. Families are identified for receiving the facilities based on a database prepared as per the Socio-Economic Caste Census, using the deprivation criterion.

Scope for Improvement in PM-JAY

While the PM-JAY scheme has achieved a lot, there is still much to be done. Here are a few areas where the scheme could see improvement:

• Despite the significant increase in funds allocated for PM-JAY, the funds for the National Rural Health Mission (NRHM) have increased only by 2%. This means that the scheme is consuming a major chunk of NRHM funds.
• Private sector hospitals are allowed to provide healthcare services to people under this scheme. However, in many remote places in India, there are no private hospitals. Even access to government Health and Wellness Centres (HWCs) is limited. This means that the marginal population living in these areas is largely deprived of the benefits of this scheme.
• There is a need for many trained healthcare professionals for the successful implementation of such a nationwide scheme; unfortunately, this is currently not the case.
• Many primary healthcare centres lack basic facilities such as electricity and water supply.
• Economically weaker sections that fall under the organized sector and have no access to health insurance are excluded from this scheme.

The Pradhan Mantri Jan Arogya Yojana, being the largest government-funded healthcare programme globally, has become an important part of the UPSC syllabus. IAS aspirants and students preparing for other government exams 2022 should have a thorough understanding of this scheme.