Modicare : A Game Changer

In his budget speech yesterday, Shri Jaitley announced launching of .

Ayushman Bharat [ National Health Protection Scheme ]

It will be a game changer

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HIGHLIGHTS :

·         It will cover 10 crore poor families ( approx. 50 crore persons ; 40 % of our population )

·         It will pay insurance premium for coverage of Rs 5 lakh claims per family per year

·         At Rs 5,000 premium ( for Rs 5 lakh ) , total cost to government could be Rs 50,000 cr / year.

Some other estimates place the annual outgo on premium of between Rs 2 – 2.5 lakh*crore

·         Because of the huge size of the scheme, government will be able to negotiate the cost of the medicines and the services

·         Budget allocation = Rs 2,000 crore

·         It will subsume earlier scheme  “ Rashtriya Swasthya Bima Yojana “ of Rs 30,000 / year claim

·         It will be the biggest such Health Insurance Scheme, anywhere in the World

·         Details of the mechanism of the scheme are yet to be worked out and announced

·         Budget also allocated Rs 1,200 crore to create “ Health and Wellness Centres “ in India’s 1.5 lakh “ Health Sub Centres “ , to provide free essential medicines closer to home through primary , secondary and tertiary health systems

·         Budget also allocated Rs 600 crore for nutritional support at Rs 500 per month to TB patients ( which infects an estimated 27.9 lakh people each year and kills 4.23 lakh persons )

=================================

COMMENTS :

·         Opposition parties say : This is a “ Jumla “ and will flop like the earlier scheme

·         Experts say : We just don’t have any experience in running such a massive scheme

·         Economists say :  Where is the money ?

·         Pratap Reddy ( Apollo Hospital ) says :  This will be a game changer

·         R Sabesan ( Dr Agarwal group of Eye Hospital ) says : It will allow mid-sized healthcare players to invest and thereby improve the quality of healthcare in the country

·         Shailaja Chandra ( Former Secretary at the Health Ministry ) says : Insurance companies could end up reaping the benefits of the health coverage scheme . There is a need for a regulatory mechanism to make sure they pay patient bills without delay

·         Indranil Mukhopadhyay ( Asst Prof , Jindal University ) says : The allocation the government would need to pay for just the premiums is about Rs 1.2 lakh*crore and the country’s total spending on health is about Rs 1.3 lakh* crore. There is no clarity on how this will be rolled out and who will foot the bill - a plan that mirrors the confusion of the 2016 proposal . There has been barely any follow up action on the past UHC announcements

·         Antony Jacob ( Apollo Munich Health Insurance ) says : The medical services sector is optimistic about the scheme leading to large-scale employment opportunities . It will help create several lakh new jobs as new healthcare facilities will come up in smaller districts and villages

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Sad Thing :

·         No one has come up with a concrete proposal which says : Here is how we can make it work

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MY SUGGESTIONS :

·         The scheme must cover

        #    Supply of Medicines / Medical Devices ( both , preventive and curative )

        #    Delivery of Services ( Diagnostic /  Nursing  /  Hospitalization )

        #    Pregnancy / Delivery related medicines / investigations / hospitalization

        Prices for each / all of these must be fixed and published , not only on the web

        site of the Health Ministry but at ALL places where medicines or services are

        getting delivered

·         Each eligible family member to be issued a “ Ayushman Card “ ( linked to Aadhar ID )

Ayushman card will have inbuilt memory capacity to store that person’s health data from “ Cradle to Grave “ ( Privacy advocate need not worry ! )

All the Health Data of all 50 crore beneficiaries to be stored on a Central Server for BIG DATA analysis , in order to “ Predict “ WHO might become susceptible to WHICH ailment and WHEN

As an alternative , a GPS enabled / NFC capable Smart Phone pre-loaded with AYUSHMAN MOBILE APP , could be considered to replace the card

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·         Ayushman Eco System shall consist of :

#    50   crore poor beneficiaries

#    All Medical Practitioners of India  ( Allopathic - Ayurvedic – Homeopathic )

   #     All Medical Shops of India  ( including  E – Pharmacies  )

   #     All  Nursing Homes / Hospitals / Diagnostic Centres / Health Centres etc

   #     All Pharma Companies

      #      Health Ministry

      #       All India Medical Association

      #       All India Organization of Chemists and Druggists ( AIOCD ) 

       #       Drug Controller General of India

       #       All  Medical  Colleges /  Medical Research Centres

       #       Any other entity which I might have missed out

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·         The Ayushman Eco System shall be built around the BLOCK-CHAIN technology , which will be the main operating system for implementation of the AYUSHMAN PROCESSES , described in my following earlier blogs ( sent as emails to Cabinet Ministers / Niti Aayog )

As to the relevance of BLOCKCHAIN technology to a Healthcare Eco-System , read :

BlockchainTechnology Could Revolutionize Health 

Care

 

https://www.investopedia.com/news/blockchain-tech-could-restructure-health-care/

Consulting firm Deloitte believes that "blockchain technology has the potential to transform healthcare, placing the patient at the center of the healthcare ecosystem and increasing the security, privacy, and interoperability of health data."

Medicalchain, on the other hand, uses blockchain technology to store and share health records securely, allowing for easy and safe transfer of information between providers and patients.

The  Bounty of Big Data  [ 30  April  2016  ]

https://myblogepage.blogspot.com/2016/04/the-bounty-of-big-data.html

3 D -Digital Delivery of Drugs ?  [  11  Oct  2015  ]

https://myblogepage.blogspot.com/2015/10/3-d-digital-delivery-of-drugs.html

Online Sale of Medicines ?  [  24  Dec  2016  ]

https://myblogepage.blogspot.com/2016/12/online-sale-of-medicines.html

 

Health Care through Mobile ?  [  24  Nov  2016  ]

https://myblogepage.blogspot.com/2016/11/health-care-through-mobile.html

 

A Mobile App named " BANMALI "  [  16  Sept  2016  ]

https://myblogepage.blogspot.com/2016/09/a-mobile-app-named-banmali.html

 

BANMALI is the TOTAL SOLUTION  [  14  Nov  2016  ]

https://myblogepage.blogspot.com/2016/11/banmali-is-total-solution.html

 

Saving 1.2 million Kids  [   29  June  2016  ]

https://myblogepage.blogspot.com/2016/06/saving-12-million-kids.html

 

Can Akshay Patra Banish Malnutrition ? [  05 June  2017  ]

https://myblogepage.blogspot.com/2017/06/can-akshay-patra-banish-malnutrition.html

 

 

PROCESS  :

 

·         Beneficiary getting AYUSHMAN Card after authentication from nearest Health Centre

 

·         Beneficiary approaching any Registered Medical Practitioner ( RMP ) for ailment

 

·         RMP entering Diagnosis / Prescription in Mobile App ( or in Card using Card Reader )

 

·         Beneficiary presenting card at the premises of delivery of Medicines / Devices / Services as prescribed by RMP

 

·         Person delivering medicines / service , entering the details in Card and delivering service ( including no of items / unit price / GST etc )

 

·         Beneficiary “ sign off “ ( in Card ) for having received medicine / service

 

·         Person delivering service ( or medicine ) , uploading data on Central Server of Health Ministry

 

·         Health Ministry updating PATIENT HISTORY in the database and effecting DIGITAL PAYMENT to person delivering medicine / service [ DBT ]

 

·         There will be NO CASH TRANSFER to a beneficiary ( to avoid fraud / fake cases )

HOW  WILL THIS  BE  A  GAME  CHANGER  ?

 

·         If meticulously designed and aggressively / speedily implemented as outlined above , AYUSHMAN has the potential to,

 

    #   Save millions of premature deaths annually

 

    #   Save billions of man-hours lost due to preventable illnesses

 

    #   Bring down the cost of Healthcare / Medicines / Services

 

    #   Vastly improve the quality of life for 50 crore persons

 

    #   Invigorate many industries and generate huge employment

 

    #   Enable BJP to return to 2019 Lok Sabha with 400 + seats

 

For NDA Ministers and Bureaucrats who have successfully carried out big ticket reforms such as De-Monetization / GST / Digital India / Bank Recapitalization etc, this is a worthy challenge

 

Let them not forget that the entire World is watching this INNOVATIVE SOCIAL SECURITY experiment

 

 

02  Feb  2018

www.hemenparekh.in / blogs

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Tech-enabled Healthcare system : 4 years in making ?

 [ 27 May 2022 ]

 

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Added on  01 JUNE  2022 :

For real-time update, NHA launches online public dashboard for Ayushman Bharat Digital Mission

{  Eco Times  /  31  May 2022 } ..

 The dashboard captures data related to the number of ABHA generated, the number  of healthcare professionals like doctors, nurses etc registered. and Digital Health records linked with ABHA

The dashboard also has granular details in relation to number of health facilities like hospitals, laboratories etc registered on a daily basis a well as cumulative till date

It further said that partner-wise data of ABHA generation created and Digital Health records liked are made available on the dashboard in real time

As per the Dashboard , as on 30 May 2022, 

#  the total number of ABHA ( earlier known as Health ID ), created is..... 22.1  Crore

#  over 16.6 thousand healthcare professionals have registered in the HPR

#  over 69.4 thousand health facilities have registered in the HFR

#  over 1.8 lakh Health Records already linked by users 

#  and the recently revamped ABHA app has crossed 5.1 lakh downloads

The Health Ministry said all the stakeholders can easily access the ABDM public dashboard from the ABDM website

=================================================================

Added  on  28  July  2023 :

Government to launch Ayushman Bhav to achieve 100 per cent coverage of health schemes  

Extract :

The Union health ministry is planning to launch ‘Ayushman Bhav’ programme to ensure optimum delivery of all state-run health schemes to every intended beneficiary, including those in the last mile.Ayushman Apke Dwar 3.0, Ayushman Sabha, Ayushman Mela and Ayushman Gram are some of the activities planned under the programme, official sources told a news agency.

“The aim of the campaign is to ensure comprehensive and saturation coverage of all health schemes so that every eligible beneficiary is able to avail their benefits,” an official source said.

Ayushman Apke Dwar 1 and 2 drives have been conducted successfully. Under the Ayushman Apke Dwar 3.0, an intensive drive will begin from August 1 to ensure full saturation, the sources said.

Ayushman Sabha will be a village-level campaign led by the village health, sanitation and nutrition committee to ensure the benefits of all the health schemes of the central and state governments reach the intended beneficiaries, they said.

These will also enhance awareness about the importance of Pradhan Mantri Jan Arogya Yojna (PMJAY) health insurance scheme cards and their distribution and generating Ayushman Bharat Health Accounts (ABHA) numbers, they said.

The campaign will also help in making people aware about the importance of utilising screening services for non-communicable diseases (NCD) and sickle cell disease through health and wellness centres and also about communicable diseases such as elimination of tuberculosis, among others.

“These village sabhas will also help in generating awareness about reproductive and child health issues, immunisation, nutrition and anaemia. Besides, they will foster social accountability of the health systems to the community to express their issues and concerns related to the health services provided at AB-HWCs,” an official source explained.

Ayushman Sabhas will be organised in each village where PMJAY cards will be distributed and information provided about PMJAY empaneled hospitals in the area and what all packages of treatments can be availed under the scheme.

The third pillar of Ayushman Bhav programme — Ayushman Mela — will be held at the level of Ayushman Bharat Health and Wellness Centres (AB-HWCs). As part of it, medical camps will also be organised at medical colleges at community health centre level.

“There are 705 medical colleges, both in public and private sector. So each medical college may organise around 50 medical camps annually and target at least 300-400 OPD treatments.

“All medical colleges together may be able to give treatment to at least 1.25-1.5 crore patients per every in camo mode at community health centres,” the source said

These will also be used for routine immunisation, NCD screening, mental healthcare, elderly care services, among others.

They can be conducted on a weekly basis.

“The objective is to reach those people who are excluded from speciality health services and make available specialty medical services up to block level which have a shortage of specialist doctors,” the official source elaborated.

The fourth pillar Ayushman gram is envisaged to achieve 100 per cent coverage of PMJAY card distribution, ABHA id generation, immunisation coverage, NCD screening, among others.

“Whichever village will be able to saturate all the schemes, it will be declared an Ayushman gram and also will be given a certificate,” the source said.

 

It is not that simple !

Times of India ( 30 Jan ) carries following news :

“ HC wants to know how many people have more than one car “

 ‘ Do Buyers Have Parking Space For New Cars ? ’

The Bombay high court on Monday directed the Maharashtra transport department to furnish data on how many persons in Mumbai had more than one car registered under their names.

The bench asked the authorities to submit details of vehicles registered in Mumbai in a day. The judges sought to know from the state government and the BMC about steps taken to verify if new buyers of four-wheelers in the city had sufficient parking space for their vehicles.

“ There is tremendous pressure on local infrastructure. You are depriving an ordinary person who cannot afford a car from even using the road as there is no space for pedestrians to walk,” said Justice Patil.

 “ Already, there are over 32 lakh vehicles in the city. You cannot allow the situation to worsen."

The court suggested once again that it was necessary to put restrictions on persons who buy new vehicles.

“ Individuals are buying more than one car. You should place restrictions and permit registration of a new car only if the owner proves he has place to park it.” The bench, headed by Justice Patil, had made the suggestion in 2015.

Advocate Sharan Jagtiani, appointed as amicus curiae (friend of the court) to assist the proceedings, pointed to an affidavit where a deputy town planning officer had mentioned that legislation is pending before Parliament to make it mandatory to show availability of parking as a pre-condition for registration of vehicles.

The bench said the city needs more parking spaces. “Mumbai needs more multilevel parking lots ? There is no reason why restrictions in place in other cities on the entry of vehicles cannot be placed in Mumbai. Think about vehicular pollution and the impact it has on the health of children,” the judge said.

The court has scheduled the matter for further hearing on February 2016. Raiyani cited press reports to point out that while the vehicle count in Mumbai had increased, the city’s length of roads had remained constant at 2,000 km for many years.

MY  TAKE  :

There can be no argument about the need to reduce traffic congestion and vehicular pollution in Mumbai / Maharashtra / India

It is also very clear that the “ Long Term “ solution lies in “ Efficient Public Transport “

There may even be some case for various “ Short Term “ measures such as :

·         Restricting entry of outside vehicles

·         Restricting only ONE CAR per family ( - or , was that “ one car per person “ ? )

I urge all the stake-holders to examine PROS and CONS of each solution , in light of the following views / arguments :

Alibaba to take on Kuala Lumpur’s traffic in first foreign project 

https://www.thestar.com.my/tech/tech-news/2018/01/29/alibaba-to-take-on-kuala-lumpurs-traffic-in-first-foreign-project/ 

Alibaba Cloud, the cloud computing arm of Alibaba Group, said on Monday it plans to make live traffic predictions and recommendations to increase traffic efficiency in Kuala Lumpur by crunching data gathered from video footage, traffic bureaus, public transportation systems and mapping apps

POLLUTIONSOLUTION , aka " PollSolv " [  30  Dec  2015  ]

https://myblogepage.blogspot.com/2015/12/pollution-solution-aka-pollsolv.html

PUBLICTRANSPORT AS A SOLUTION ?  [  16  Feb  2016  ]

https://myblogepage.blogspot.com/2016/02/public-transport-as-solution.html

One Carper Family ?  [  27  Sept  2016  ]

https://myblogepage.blogspot.com/2016/09/one-car-per-family.html

A KneeJerk Approach ?  [ 22  Dec  2016  ]

https://myblogepage.blogspot.com/2016/12/a-knee-jerk-approach.html

Un-ImplementableLaws : Unstoppable Corruption [ 20 Feb 2017 ]

https://myblogepage.blogspot.com/2017/02/un-implementable-laws-unstoppable.html

Internetof Vehicles ( IoV ) ?  [  04  Mar  2017  ]

https://myblogepage.blogspot.com/2017/03/internet-of-vehicles-iov.html

UrbanTransport Policy  [  09  June  2017  ]

https://myblogepage.blogspot.com/2017/06/urban-transport-policy.html

Whydon’t they park in their flats ?  [  01  Sept  2017  ]

https://myblogepage.blogspot.com/2017/09/why-dont-they-park-in-their-flats.html

ATrail-Blazing Urban Transport ?  [  22  Sept  2017  ]

https://myblogepage.blogspot.com/2017/09/a-trail-blazing-urban-transport.html

ParkingMess ? It will get worse !  [  01  Jan  2018  ]

https://myblogepage.blogspot.com/2018/01/parking-mess-it-will-get-worse.html

31  Jan  2018

www.hemenparekh.in / blogs

PM says : Look East

When Shri Modiji says , “ Look  East “ ,  it is for a good reason

Following news reports prove his point :

COMPARE  and  CONTRAST :

IN MAHARASHTRA :

“ 6.7 million kids below 5 in Maha breathe dangerously toxic air “ 

https://www.hindustantimes.com/mumbai-news/6-7-million-children-below-5-years-breathe-dangerously-toxic-air-in-maharashtra-shows-study/story-mrWxEtAWkokDGBo0hPBzhI.html

Around 6.7 million children below five years of age in Maharashtra are inhaling particulate matter (PM10) that is above the permissible limits set by the law, revealed the second edition of air quality report in India by Greenpeace India on Monday.

The report also said 1.4 million of these children are exposed to twice the pollution standards.

Additionally, 2.6 million children live in districts where there are no air-quality monitoring stations.

Exposure to high levels of PM10 — they are fine harmful solid and liquid particles floating in the air with a diameter of 10 microns — leads to respiratory and cardiovascular diseases, and premature death.

 “It’s time we understand the sources of pollution. While India does have guidelines for outdoor pollution, we need to study indoor air pollution, which is a much-neglected issue right now that has no prescribed emission limits,” said Avick Sil, regional director, Environment Policy and Research India, who was not part of the Greenpeace study.

“Similar to measuring ground-level ozone, there is a need to also study particulate matter at the ground level. A comprehensive air pollution mitigation policy can be thought of only if we look at both forms of pollution,” he said.

Across India, about 47 million children below 5 years live in areas where PM10 levels exceeded annual air pollution limits, including 17 million children under the same age in areas where pollution levels are more than twice the prescribed limits.

The latest version of the Airpocalypse II report, which analysed PM10 annual average of 280 cities across India with a population of 630 million, found that in 2016, none of the 24 cities and towns across Maharashtra with air quality monitoring facilities complied with the annual PM10 air quality standards set by the Central Pollution Control Board (CPCB).

Six of the 24 locations recorded annual PM10 levels twice the permissible limit of 60 micrograms per cubic metre (ug/m3) by CPCB, and almost seven times above the standard of 20ug/m3 by the World Health Organisation.

Nanded recorded the highest annual PM 10 levels at 151ug/m3, followed by Dombivali (140ug/m3), Mumbai (130ug/m3), Akola (123ug/m3), Badlapur (122ug/m3), and Ambernath (121ug/m3)

In addition to Mumbai, the annual PM10 levels for other major cities of Maharashtra stood at 117ug/3 at Thane followed by Pune (99ug/m3), Nashik (86ug/m3), Nagpur (82ug/m3), Navi Mumbai (93%), and Panvel (118ug/m3).

“This report, which is second in the series after last year, once again raises an alarm for regions like Maharashtra where the air pollution situation is already at hazardous levels and increasing day by day,” said Sunil Dahiya, senior campaigner, Greenpeace India.

Dahiya added, “Cities like Mumbai should lead by examples of not being on list of most polluted and unhealthy cities to live in, but in being the cities where clean air, environment and health is prioritized to provide better quality of life for public.”

In 2017, the MPCB, based on the National Clean Air Programme, started the process of formulating an action plans to mitigate air pollution for multiple cities in the state. “We have had consultation meetings with various stakeholders and agencies such as municipal corporation, National Environmental Engineering Research Institute and the Indian Institute of Technology - Bombay. We are in the process of drafting an action plan,” said VM Mothghare, joint director, MPCB.

The Greenpeace India report used monthly PM10 data for 2016 from the Maharashtra Pollution Control Board (MPCB), and 65 manual and continuous air quality monitoring stations. The report found that 23 states had no real-time air quality monitoring data available to citizens – highest real-time coverage was found in Delhi followed by Maharashtra and Andhra Pradesh.

IN  BEIJING  :

“ Beijing plans to spend $ 3 billion this year to fight air pollution “ 

https://www.hindustantimes.com/world-news/beijing-to-spend-3-billion-in-2018-to-combat-air-pollution/story-sn5dtdfz1NFWlPjjoui04H.html

Beijing, which suffered heavy pollution for years, plans to spend over 19 billion yuan (about $3 billion) to reduce air pollution in the Chinese capital this year.

It marks a yearly increase of 590 million yuan, according to statistics released at the on going annual session of the 15th Beijing Municipal People’s Congress.

The money will be used to control pollution sources such as coal, vehicles and dust, and to support projects to replace coal with clean energy in rural areas, according to a draft of the 2018 Beijing budget report.

The smog-prone Chinese capital has intensified measures in recent years to improve its air quality. So far this year Beijing has more clear sunny days than compared to the previous years though smog reappears when there was no heavy wind.

In 2017, Beijing switched 901 villages from reliance on coal to clean energy and phased out nearly half a million out-dated vehicles.

Almost no coal consumption takes place in Beijing’s six districts and its southern plain areas, state- run Xinhua news agency reported.

The average density of PM 2.5 in Beijing was 58 micrograms per cubic meter last year, meeting the target set by the State Council, and 20.5 per cent less than in 2016.

According to the municipal congress, Beijing plans to invest more than 67 billion yuan for environmental protection this year in sectors such as air pollution, water and soil improvement, as well as integrated garbage treatment.

================================

Dear Shri Devendra Fadnavisji ,

I have no doubt you too could bring about even better improvements if you make up your mind to save millions of young lives

And funds cannot be a constraint, considering that Mumbai Municipal Corporation is sitting on a pile of cash – Rs 74,000 Cr ( approx. $ 12 billion ) – as fixed deposits in various banks ( - earning Rs 7,000 cr by way of interest , annually )

There can be no better way to put this to use !

31  Jan  2018

www.hemenparekh.in / blogs

Aadhar : Supreme Asks : What if ?

Today’s DNA carries following news :

“ Must examine if Aadhar data can be misused : SC “ 

https://www.hindustantimes.com/india-news/sc-questions-balance-between-linking-of-aadhaar-welfare-schemes-protecting-data/story-gHQC7xnW9rztysNlSgSpVO.html

Justice Chandrachud remarked and asked advocate Shyam Divan :

·         This programme is not just the envy of North Korea but also the World Bank

·         The positive aspect of Aadhar is that for the first time there is a citizen-centric delivery of services . This is exactly the part of Aadhar that has been appreciated by economists

·         Let’s not stretch it too far. Ultimately we are all part of a highly networked World

·         The involvement of the Indian Government in developmental programmes is higher

·         The NHS ( in the UK ) may be an exception, but there is nothing like an MGNREGA there

·         The profiling of people and their private affairs cannot be allowed

·         What is the scope for misuse in the future ? That is important. But we cannot discount that the government can’t use it to ensure the identities of beneficiaries. If the aggregation is only for purpose of social welfare benefits, will that not pass muster ?

Dear Justice Shri Chandrachudji ,

There is no doubt you are bored listening to the same stale arguments re “ Privacy of Personal Affairs “

But you are obliged to give a patient hearing to the advocates of the petitioners

That does not stop you from asking them to view the following video of the famous theoretical physicist , Dr. Michio Kaku , before the next date for hearing :

“ Michio Kaku’s biggest predictions about the Future 

“ 

https://futurism.com/michio-kakus-biggest-predictions-about-future/

And , in case the advocates are wearing any FITNESS devices on their wrists, they may also want to find out what the ENTIRE WORLD knows about their private lives , by reading :

Strava’s fitness tracker heat map reveals the location of military bases 

https://www.theverge.com/2018/1/28/16942626/strava-fitness-tracker-heat-map-military-base-internet-of-things-geolocation

 

=================================

 

I think it is time to admit that :

“ Privacy will be an alien concept by 2020 “

Committee on proposed “ Data Protection Law “ ( headed by Shri B N Shrikrishna ) would also benefit by going through these links

 

31  Jan  2018

www.hemenparekh.in / blogs

Future