IRAN’S Universal Healthcare Program Vs INDIA’S Ayushman Bharat Program

BY: Deepak Singhal

In 2014, Iran rolled out a grand vision for a universal healthcare insurance. Hailed as a landmark reform by the Ministry of Health, the policy aimed to democratize healthcare access across the nation. However, nine years down the line, it’s time to examine the prescription.

Despite decades of policy interventions, Iran’s progress toward Universal Health Coverage remains suboptimal in critical dimensions such as equitable access, service coverage, and financial protection. Instituted in 2014, the Health Transformation Plan sought to ameliorate these deficiencies. The plan facilitated an expansion of coverage, encompassing an additional 11 million previously uninsured individuals, predominantly from the self-employed sector. Moreover, it aimed to alleviate out-of-pocket expenditures in public healthcare facilities. Financial underpinnings for the Health Transformation Plan were sourced from targeted subsidies and a portion of the value-added tax.

Iran’s healthcare plan has had some success but also faces big challenges, especially in paying for the program in the long term. To improve healthcare for everyone, government departments need to work together to control costs, which could include measures like broadening family doctor programs and setting up clear treatment guidelines. The reality was that the costs weren’t managed well, and the government may have to cut free healthcare or make people pay more, making healthcare harder to access for many. As a result, following the National Health Accounts, out of pocket expenses for the whole population increased from 46.2% in 2003 to 53.8% of total health care expenditures in 2008.

Additionally, a lot of outpatient and basic health services in Iran are provided by private hospitals, which can be expensive and aren’t covered by the government plan. This makes it crucial for the government to improve public hospitals, especially in poorer areas. Balancing the costs between public and private healthcare is important. With extra financial challenges like international sanctions and the COVID-19 pandemic, it’s even more important to think carefully about how to make healthcare affordable and sustainable for the long run.

To make healthcare better in Iran, it’s important for government ministries to work together to control costs. They could expand the family doctor program to more areas and make sure treatments are cost-effective. It’s also important to improve public hospitals, especially in poorer areas, to take the pressure off expensive private ones. To fund all of this fairly and keep it going long-term, the government needs a clear payment plan, especially given extra challenges like international sanctions and COVID-19. Regular checks should be made to see if the plan is working.

Ayushman Bharat Program is a flagship health protection scheme launched by the Government of India in 2018. It aims to provide universal health coverage to the poor and vulnerable sections of society by ensuring access to quality healthcare services agnostic of economic status. It has the potential to transform the healthcare landscape of the country by reducing poverty, enhancing productivity, and promoting social justice. As AB-PMJAY completes its fifth year, it has covered more than 15.5 crore families (about 50 crore beneficiaries) with a health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalization. Eleven states/UTs have pushed for 100% coverage of their respective population.

The scheme has catered to more than 5.39 crore admission events worth Rs 66,284 crore in the last five years. If the beneficiaries had availed the same care outside AB-PMJAY’s ambit, the total cost of treatment would have been nearly two times higher. This has resulted in savings of more than Rs 1 lakh crore for the beneficiaries.