The goal is not only to make private care more accessible for seniors, but also to strengthen and rely on the public healthcare system.
The central government’s decision to extend the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to cover medical expenses in the private sector for persons over 70 years old is a positive step. The initiative was necessary due to rising medical expenditures in the private sector, limited access to quality care in public facilities, and decreasing incomes for the elderly. The recent decision by the insurance regulation to lift the 65-years cap on health insurance may make healthcare more affordable for the silver generation, which accounts for approximately 10% of the population (104 million).
However, this action is insufficient for three reasons.
Many older people reside in areas with limited access to private healthcare, resulting in a policy that promises welfare but fails to provide in reality. This insurance does not cover outpatient treatment, diagnostics, and drugs, which are significant medical expenses for seniors. Reports indicate that 40-80% of expenses are spent on outpatient care, depending on the state.
According to this perspective, by limiting care to intermediate and tertiary levels, the policy falls short of addressing those in greatest need. The PM-JAY scheme has been strengthened by allowing the elderly to access the private sector, which typically operates in tertiary care or specialised hospitals. In the southern states, nearly 53% of PM-JAY spends go to the private sector, while in other states, two-thirds go to the private sector, which is typically limited to urban areas.
These changes may lead to a reduction in public healthcare systems across the country and a strengthening of the US model, which is now ineffective. The withdrawal of the public sector from healthcare puts millions at risk, including those who cannot afford private treatment or rely on PM-JAY due to limits. This also puts the country’s health on a precarious path. The goal is not only to make private care more accessible for seniors, but also to strengthen the public healthcare system so that it can provide care to everyone.
