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2019-01-15

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Developmental Issues
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Three-and-a-half months is too short a period to judge the performance of any policy. The period is definitely too brief for the Pradhan Mantri Jan Arogya Yojana (PMJAY) to come into full play. Even then, West Bengal’s withdrawal from the Centre’s ambitious health insurance scheme, last week, raises disturbing questions. The state government’s reason for the move bares the fact that ownership of the project remains a fraught issue. West Bengal Chief Minister Mamata Banerjee has alleged that the Centre is taking “all credit” for the scheme. She said that her government will not honour its commitment to pay 40 per cent of the scheme’s expenses because pamphlets being distributed by Ayushman Bharat — PMJAY’s nodal agency — “mention the name of the Prime Minister and have his photograph”. This certainly smacks of petty politics. However, West Bengal’s exit from the PMJAY also speaks poorly of the Centre’s efforts to make the states, especially the ones where the NDA does not hold office, partners in its flagship project.

Punjab, Delhi, Kerala, Telangana and Odisha — non-NDA-ruled states — had opted out of the PMJAY when the programme was launched. But Kerala and Punjab eventually agreed to implement the scheme. Delhi, Telangana and Odisha, however, continued to raise issues over converging their existing health programmes with the PMJAY. West Bengal too had similar reservations to begin with, but the state government came around to aligning its existing scheme, Swasthya Saathi, with the Centre’s programme. This decision meant that an additional one crore people in West Bengal got a health insurance cover. But the state’s volte face means that these beneficiaries stand to lose out.

PMJAY’s architecture gives states the flexibility to decide the modalities of implementation. But Delhi, Telangana and Odisha’s objections show that more work needs to be done in this respect. The greater problem, however, is that the boundaries between genuine differences over modalities and politicking have become blurred. The three states, for instance, claim their policies are better than the PMJAY. Instead of finding ways to end the stand-off, the Centre has often resorted to grandstanding. Union Minister of Textiles Smriti Irani had berated Odisha CM Naveen Patnaik for withholding the benefits of Ayushman Bharat from the state’s people. West Bengal’s withdrawal signals a new low.

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