Andhra Pradesh has the unique distinction in the country for having initiated and adopted some of the most innovative healthcare and heath insurance schemes for the benefit of the poor.
The state had launched unique kind of pro-poor health insurance schemes like Rajiv Arogysri, Jeevandhara generic drug scheme and recently organ transplantation programme for the benefit of poor patients.
In fact, the health sector in Andhra Pradesh has built synergy with national Rural Health mission (NRHM) which is a health sector reform programme of the central government for decentralization, pro-poor focus and strengthening service delivery. The health sector support provided over the past few years was aimed at increased use of quality health services, especially by the poorest people and in under served areas.
Andhra Pradesh’s budget allocation for the medical and health department for the year 2012-13 is Rs.5889 crores, compared to the Rs.5040 crores in the year 2011-12. This a substantial increase of 16.86 per cent over last year.
While for Arogysri , Rs 1400 crores is allocated every year for treating the poor living under BPL.
It is well said that ‘Health is Wealth’ and of course it is, because without proper health it is impossible for anyone to achieve success in life. In fact maintaining good health is the first step towards success in life. Realizing this fact, the state government of Andhra Pradesh had come out with a novel health insurance scheme called “”Rajiv Arogyasri” for the poor people living below the poverty line.
It was late Dr. YS Rajashakara Reddy, former Chief Minister of Andhra Pradesh who had envisioned this novel scheme for the healthcare needs of the poor people.
During the last seven years, the government had done a great service for the welfare of the poor people especially in the health sector.
The 108 and 104 ambulance services have done a commendable job in saving millions of lives of the poor and people who met with unfortunate accidents and other ailments. The 104 services are further more helpful especially for the women folk in the villages. The services has penetrated deep into the rural areas.
Despite the excellent primary and secondary health infrastructure in public and private sector in the state health outcomes are not commensurate with the investments made. While timely access to quality and affordable health care, reduction in maternal mortality, infant and under five mortality, universal coverage under the Tuberculosis control program, eradication of leprosy or containment of malaria and other infectious diseases continue to be problematic. The disease burden in 2015 on account of non communicable disease is also estimated to be unsustainable levels. Illness continues to be a major cause of rural indebtedness.
The health care services in AP are financed in two ways-out of pocket by individual households and through the state budget out of taxes. User fees which used to fund one third of non salary expenditure have since been abolished. Insurance as a form of financing is restricted to a small segment of upper middle class household under voluntary, private commercial insurance programmes. Due to rapid increase in the prices of inputs and technology, shifts in perception and disease profiles towards illnesses that are more expensive to threat, a critical concern in the need to sustain the present system of healthcare and ensure access to quality care.
Arogyasri health insurance scheme
Rajiv Arogyasri health insurance scheme is being implemented in Andhra Pradesh to assist poor families from catastrophic health expenditure. The scheme is a unique PPP (Public private partnership) model in the field of health insurance tailor made to the health needs of poor patients and providing end-to-end cashless services for identified disease through a network of service providers from government and private sector. The scheme was introduced in 2007 in three backward districts of Mahaboobnagar, Ananthapur and Srikakulam on pilot basis and was subsequently extended to the entire state in phased manner to cover 20.4 million BPL families encompassing ,70 million pollution spread across 23 districts.
Initially the scheme started with coverage of 163 identified disease in six systems and was gradually extended to 330 diseases in 13 systems under Arogyasri-1. The coverage under the scheme was extended to 942 procedures in 31 systems with additional of 612 procedures through Arogyasr-11. The scheme was formulated in consultation with specialists in the field of Medicine, Health and insurance to address the needs of catastrophic health expenditure among the BPL families of the state and at the same time not to sideline the existing infrastructure in government hospitals.
First generic drug outlet
Among its recent initiatives, the Jeevndhara subsidized drug stores out let is another innovative move by the health department of the state. Moving forward the government of Andhra Pradesh is taking steps to set up a series of generic drug stores in Hyderabad with the collaboration of Red Cross and the AP Senior Citizen’s confederation.
As a part of this initiative, the government has inaugurated first of its kind Jeevandhara stores at Osmania General Hospital which is followed by outlets at Gandhi and other government hospitals across the state.
Earlier during last year, the government had started Jeevandhara Sanjeevani Pharmacy as a pilot project at King George Hospital in Visakhapatnam. This has become a great success as it had provided more than 333 varieties of generic drugs from reputed 20 pharma companies.
The main objective of the scheme is to provide quality medicines at affordable prices for all. As the healthcare costs are increasing day by day, the government had felt that Jeevandhara is the only way through which the poor patients can be served with quality medicines for cheaper rates. The concept of Jeevandhara was developed by J.Syamala Rao, former collector Visakhapatnam and MD of APMSIDC (Andhra Pradesh Medical services and infrastructure Development Corporation).
In fact almost 50 per cent of Andhra Pradesh’s healthcare costs go towards procuring medicines and yet 65 per cent expenditure is incurred by the public in purchasing drugs. The government has taken a serious note of this issue and has decided to provide high quality drugs manufactured by top pharma companies at affordable prices to the poor through the Jeevandhara outlets.
Uday Bhasker, general manager of Jeevandhara Generic Drugs concept and secretary-general of all India Drugs Control officers’ confederation informed that most pharma companies in India manufacture generic drugs under a brand name and these are popularly known as branded generics.
The same company manufactures branded and unbranded generic drugs, having the same composition, but there is a huge difference in the ex-factory price and MRP of branded generics varying from 50 per cent to 100 per cent.
“The unbranded generic equivalents are equally good in therapeutic value compared to the branded medicines. Moreover there are no separate standards for generic and branded drugs. As per the drug and cosmetics Act, every drug has to pass the specified parameters. So why should one buy costly medicines when we can get the same drug with a lower price. The Jeevandhara employs this concept and it will really help the poor in giving them new lives at affordable prices,” said J.Syamala Rao, MD, APMSIDC.