Curriculum Health Insurance and Ayushman Bharat
Health Insurance and Ayushman Bharat
India's health financing: why health costs impoverish, PM-JAY basics, how it works, gaps and criticisms, fraud and governance, private health insurance, employer and social insurance, medical inflation, digital health, universal health coverage, and a recap.
- Why Health Costs Push People Into Poverty In India, most health spending is paid directly by households, so a single hospital stay can wipe out savings and push families into debt. 📄 Read-aloud
- Ayushman Bharat PM-JAY: The Basics Launched in 2018, PM-JAY offers free hospital treatment of up to ₹5 lakh per family per year to tens of crores of poorer Indians. 📄 Read-aloud
- How PM-JAY Works: Packages, Claims and Hospitals The scheme pays hospitals fixed package rates for procedures, and the National Health Authority manages claims through an IT platform. 📄 Read-aloud
- Gaps and Criticisms Awareness, uneven state adoption, claim delays and financial protection gaps for outpatient costs limit the scheme's impact. 📄 Read-aloud
- Fraud, Overtreatment and Governance Scheme funds attract abuse, including fake claims and unnecessary procedures, so audits and technology are used to detect fraud. 📄 Read-aloud
- Private Health Insurance in India Private insurers offer individual and family plans, but coverage is limited, premiums have risen and claim processes can be difficult. 📄 Read-aloud
- Health Insurance and Ayushman Bharat: Checkpoint 1 Quick checkpoint - five questions on health insurance and ayushman bharat. 5 questions
- Employer, Government and Social Insurance Government employees have CGHS, formal-sector workers ESIC, and many firms give group cover, while informal workers rely on public schemes or nothing. 📄 Read-aloud
- Medical Inflation and Hospital Pricing Hospital costs are rising faster than general inflation, and lack of price transparency makes it hard for patients to compare. 📄 Read-aloud
- Digital Health: ABHA, Telemedicine and eSanjeevani The Ayushman Bharat Digital Mission gives people a health ID and links records, while telemedicine platforms extend consultations to remote areas. 📄 Read-aloud
- Towards Universal Health Coverage Achieving universal coverage will need more public spending, stronger primary care, better regulation and sustainable financing. 📄 Read-aloud
- Health Insurance and Ayushman Bharat: Recap A recap of India's health financing challenges and reforms. 📄 Read-aloud