It is deeply unfortunate for public health that a Central scheme called “Ayushman Bharat’’ should be reduced to a subject of Centre-State kerfuffle. It is unfortunate too that West Bengal should lend its spin on health federalism, this time pertaining to a primary index of welfare and pull out of the Centre’s plan of action in the health sector. Yet the state is not alone in pulling out of the project; five states with non-BJP governments ~ Telangana, Odisha, Delhi, Kerala and Punjab ~ have signalled that they will not participate, claiming that healthcare in their respective provinces was better.
The reason proffered by the Chief Minister is weak and, therefore, unlikely to comfort the sick and the dying. Going by her presentation, Mamata Banerjee has no issue with the scheme per se; she can hardly deny that it certainly supplements the decrepit state healthcare. Medical attention in private establishments is only for those who can afford it. She has taken umbrage to the fact that Narendra Modi’s mugshot along with a visual of the lotus, the symbol of the Bharatiya Janata Party, appears on the entitlement card. Her reason, therefore, is nothing if not intensely political, fearing that the saffronite party is seeking to score brownie points in the health sector during the season of elections.
Hence the decision to discontinue the state’s share of funds towards “Ayushman Bharat,” which amounts to 40 per cent of the Centre’s health insurance scheme. However, the Chief Minister does have a point not the least because such visuals are both improper and irrelevant to the context. The Ayushman Bharat scheme in West Bengal was merged with the state government’s Swasthya Sathi Health Scheme, for which the state provides 40 per cent of the total cost. The Centre ought to respond to the charge that there is little or no transparency in the execution of the scheme as also the CM’s allegation that the PM is using India Post for party work, given that the entitlement cards are despatched through the post offices.
While the PMO’s mode of communication may not be faulted, the Chief Minister is constitutionally spot on when she contends that health, education and law and order are state subjects. Yet she is rather rhetorical when she claims that the Centre is “running a parallel government in the state”, warning the audience that “your bank deposits, pension and Provident Fund are at stake”.
Once again this is a sensitive statement in the absence of empirical evidence. That said, the fact remains that with adequate cooperation between the Centre and the states, Ayushman Bharat would have been a worthwhile essay towards streamlining public health, most particularly in rural Bengal. This is the first time that the Chief Minister has opted out of a central scheme. Shorn of ego trips and self-projection, this public healthcare scheme deserves to be given a try. Ayushman Bharat concerns the people.