Kolkata: The integration of Ayushman Bharat with West Bengal's Swasthya Sathi scheme may result in two distinct categories of beneficiaries, according to a source close to the state health department. One category would include those who qualify under the existing Ayushman Bharat criteria, while the other would cover the remaining population, particularly middle- and lower-income groups currently enrolled in Swasthya Sathi.
Two Categories Under Consideration
Under Ayushman Bharat norms, all individuals aged 70 years and above, along with those below the poverty line, are eligible. However, others must meet a stringent set of criteria that could exclude a significant portion of the state's population. Swasthya Sathi, in contrast, was a universal scheme. The source explained, "The integration process may see two categories to include those who now hold Swasthya Sathi cards but will be left out of Ayushman Bharat. So, there could be a separate set of packages and funding patterns for them. The other will be a general category for those who qualify under existing criteria."
Funding and Coverage Details
Ayushman Bharat is funded by the Centre and the state in a 60:40 ratio. The source added, "Initially, Ayushman will cover the 70-plus population and those who satisfy existing norms. In the next phase, it will be extended to the middle- and lower-income groups who were covered under Swasthya Sathi but don't fulfil Ayushman norms. The funding ratio could be different and the modalities are yet to be finalised. The coverage patterns and rates could be different for the two categories." An official confirmation was not available at the time of reporting.
Hospital Reactions
Private hospitals were divided on whether the new scheme should cover all or be restricted to the poor. Rupak Barua, president of the Association of Hospitals of Eastern India and CEO of Woodlands, said, "The two-card theory is an ideal arrangement as a state scheme needs to cover most of the population. Also, the packages need to be priced reasonably for hospitals to find it easy to accept Ayushman patients." Charnock Hospital, which is in the process of boarding the Ayushman platform, supports the move. Managing Director Prashant Sharma stated, "This will help extend the scheme to a larger section of the population. If coverage is extended through a seamless integration, we should have a sizeable section of Swasthya Sathi beneficiaries covered." Ayanabh Debgupta, regional director (east) of Manipal Hospitals, added, "Ayushman is expected to play an important role in enhancing healthcare accessibility and affordability." However, some felt that those with personal or corporate health insurance or who are financially well-placed might ideally stay outside the scheme. Rupali Basu, regional business head of HCG Cancer Hospitals, said, "It will help us look after those who truly need aid."
