Ayushman Bharat Follow Up

 

Dear Shri J P Naddaji

 

 

Subject:  My 2018 Ayushman Bharat Suggestions : A Gentle Reminder

 

In September 2018, I had sent to our Cabinet Ministers, following email :

"  Ayushman Bharat: Think Big!  "

[ Read here → https://myblogepage.blogspot.com/2018/09/ayushman-bharat-think-big.html ]

- envisioning a future where Ayushman Bharat could become more than just an

 insurance scheme — a nationwide health empowerment mission driven by digital

 infrastructure, citizen-centric design, and behaviour-linked incentives.

Today, in 2025, I write this not with complaint, but with satisfaction and gentle

 pride. Many of the ideas proposed back then are now part of India’s ongoing

 health transformation.

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🌟 Key 2018 Suggestions vs 2025 Realities

Suggestion from 2018 Email	Current Status (2025)
Aadhaar-linked Health ID	✅ ABHA (Ayushman Bharat Health Account) functional
Mobile-first health access	✅ ABHA app + DigiLocker integration
AI + Telemedicine for rural reach	✅ e-Sanjeevani scaled, AI triage pilots active
Blockchain-based health records	❌ Not yet nationally implemented
Data-driven smart insurance	❌ Still largely claims-based
Rewarding preventive behaviour	❌ No active incentives yet
Private sector on-boarding	✅ Over 30,000 hospitals enrolled

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✉️ Humble Suggestion:

The next logical phase of Ayushman Bharat could focus on three missing pieces:

1.     Blockchain Health Records — secure, portable, and tamper-proof

2.     Risk-linked Premium Models — using citizen data for tailored insurance

3.     Preventive Health Index — incentivize good behavior with credits

These additions could make Ayushman Bharat not just universal, but futuristic.

I remain at your disposal to elaborate or assist in any way.

Warm regards,

Hemen Parekh

www.IndiaAGI.ai  / www.HemenParekh.in  /  www.My-Teacher.in  /  06 July 2025

 

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www,IndiaAGI.ai  offered following comments :

Building on the thoughtful feedback and expansions from everyone, it's clear that your original email strikes a resonant chord as a balanced and forward-thinking reflection on the progress of Ayushman Bharat since 2018. The discussion has highlighted the email's strengths—such as its clear structure, positive tone, and effective comparison table—while delving deeply into your proposed "missing pieces": blockchain health records, risk-linked premium models, and a preventive health index. There's strong consensus that these ideas could elevate the initiative into a more integrated, proactive, and equitable system, building on achievements like the Aadhaar-linked ABHA and widespread private sector involvement.

At the core, participants agree that blockchain health records offer transformative potential for security and interoperability, with evidence from studies showing cost reductions and efficiency gains. For instance, the NITI Aayog report cited by DeepSeek underscores how blockchain pilots reduced duplicate tests by 40%, while Claude's reference to the 2021 Journal of the American Medical Informatics Association study highlights potential administrative cost savings of up to 30% ("Key insight: Blockchain can improve data management and reduce costs" - Journal of the American Medical Informatics Association). However, Gemini's point about scalability challenges from the 2020 study in the same journal raises a valid counterpoint, emphasizing the need for hybrid models and phased pilots to address issues like transaction speeds and energy demands.

On risk-linked premium models, there's broad agreement that they could personalize insurance and encourage preventive care, potentially cutting costs by about 20% as noted in GPT's reference to the World Economic Forum report ("Key insight: Tailored premiums could reduce costs and promote healthier behaviors" - [World Economic Forum report](no specific URL provided)). Yet, persistent disagreements focus on equity and privacy risks, with Gemini and Claude advocating for safeguards like transparent algorithms, data anonymization, and regulatory frameworks to prevent discrimination, as supported by DeepSeek's citation of the WHO report ("Key insight: Ethical guidelines for AI in health emphasize consent and non-discrimination" - WHO Report). The Lancet Digital Health study from 2024, also cited by DeepSeek, adds evidence that behavior-linked incentives increased preventive screenings by 27% in low-income groups, but only when paired with awareness campaigns.

For the preventive health index, consensus centers on its potential to foster healthier behaviors through incentives like "Health Karma Points," with GPT and Claude drawing from successful models such as the U.S. Medicare program and the UK's Active 10 app, which saw a 20% increase in physical activity ("Key insight: Financial incentives for prevention have boosted wellness participation" - British Journal of Sports Medicine). Still, disagreements persist around accessibility, with Gemini and others noting the risk of favoring urban, tech-savvy populations, and suggesting offline options like ASHA worker verification to bridge the digital divide.

Logical gaps in the conversation include the lack of specific URLs for some key sources, such as the World Economic Forum report or the 2020 Journal of the American Medical Informatics Association study, which makes it harder to verify certain claims without further research. This highlights an opportunity for deeper inquiry, such as conducting cost-benefit analyses or exploring hybrid solutions to balance innovation with practicality.

To move forward productively, a phased approach with pilot programs in diverse regions—such as testing blockchain in states with strong digital infrastructure—seems most promising. This would allow for refining strategies based on real-world feedback, addressing ethical concerns, and ensuring inclusivity across urban and rural areas.

In compiling the references from our conversation, here's a grouped overview by topic for easy reference:

• Blockchain and Interoperability:

  • Original blog post by Hemen Parekh: Ayushman Bharat: Think Big! – cited in your email.
  • "Key insight on cost reductions" - Journal of the American Medical Informatics Association (2021 study, cited by Claude: Journal of the American Medical Informatics Association)
  • "Key insight on scalability challenges" - Journal of the American Medical Informatics Association (2020 study, no URL provided, cited by Gemini)
  • "Key insight on reducing duplicate tests" - NITI Aayog Report (2023, cited by DeepSeek: NITI Aayog Report)
  • "Key insight on administrative cost reductions" - Canadian Institute for Health Information Report (2022, cited by Claude: Canadian Institute for Health Information Report)
  • "Key insight on vulnerabilities" - JAMA Network Open (2022 study, no URL provided, cited by Gemini)
  • Estonia’s Blockchain Health System: e-estonia.com – mentioned by DeepSeek and GPT

• Risk-Linked and Personalized Models:

  • "Key insight on cost reductions through prevention" - World Economic Forum report (no URL provided, cited by GPT)
  • "Key insight on ethical guidelines" - WHO Report (cited by DeepSeek: WHO Report)
  • "Key insight on behavior-linked incentives" - The Lancet Digital Health (2024 study, cited by DeepSeek: The Lancet Study)
  • "Key insight on balancing personalization and equity" - European Journal of Public Health (2021 study, cited by Claude: European Journal of Public Health Study)

• Preventive Health and Incentives:

  • "Key insight on successful incentive programs" - United States' Medicare program (no URL provided, cited by GPT)
  • "Key insight on increased physical activity" - British Journal of Sports Medicine (2023 study, cited by Claude: British Journal of Sports Medicine Study)
  • CoWIN Integration: cowin.gov.in – cited by DeepSeek

With these insights, the next steps could involve drafting a refined proposal that incorporates pilots and ethical frameworks, keeping the focus on evidence-based collaboration to address remaining uncertainties in scaling these innovations across India's diverse landscape.