Insurance And Health Indicators: How West Bengal Suffered For Not Implementing PM-JAY While Neighbours Marched Ahead

Prime Minister Narendra Modi’s pet project Pradhan Mantri Jan Arogya Yojana (PM-JAY) which was launched in 2018 to expand healthcare access to India’s poor has helped achieve strong healthcare outcomes in states which implemented the scheme, an analysis in the 2020-21 Economic Survey shows.

The percentage of households with health insurance increased by 54 per cent for the states that implemented PM-JAY while falling by 10 per cent in states that did not, says the Survey which was tabled by Union Finance Minister Nirmala Sitharaman in Parliament yesterday (29 January).

The difference is more stark when one compares states with similar socio-economic indicators. As per the Survey’s analysis, the proportion of households with health insurance increased in Assam, Bihar and Sikkim by 89 per cent while it decreased by 12 per cent in West Bengal between 2015-16 to 2019-20.

PM-JAY is currently being implemented by 32 states and union territories. West Bengal, Delhi, Telangana and Odisha governments have kept their people out of the ambit of the scheme.

To assess impact of the PM-JAY scheme on the health outcomes, the Survey compared the health indicators measured by National Family Health Survey-4 (NFHS 2015-16) and the National Family Health Survey 5 (NFHS 2019-20) thus giving the before-after data since PM-JAY was launched in 2018. with the NFHS-4 serving as the baseline to compare the changes using NFHS-5. The analysis used a difference-in-difference method so as to mitigate the impact of various confounding factors including improvements in health indicators that would’ve happened even without the PM-JAY.

One the most important conclusions that emerges from the Survey’s analysis is the insurance coverage that would’ve increased had the West Bengal government led by Mamata Banerjee approved the scheme in the border state which also happens to be one of the poorest. The number of households with insurance coverage would’ve almost doubled between 2015-16 to 2019-20 in West Bengal if PM-JAY was implemented.

The progress on health indicators would’ve also been much more significant than what has been witnessed.

Infant mortality rates declined by 20 per cent in West Bengal between NFHS-4 and NFHS-5 while the three neighbouring states - Assam, Sikkim and Bihar witnessed a decline of 28 per cent. Under-5 mortality rate fell by 20 per cent in West Bengal while the three neighbours saw a 27 per cent decline.

Increase in adoption of modern methods of contraception, female sterilization and pill usage in West Bengal were negligible while these saw a jump of 36 per cent, 22 per cent and 28 per cent respectively in Assam, Bihar and Sikkim.

Moreover, there was no significant decline in unmet need for spacing between consecutive children in West Bengal while its three neighbouring states witnessed a 37 per cent fall.

Not just West Bengal, other states which also didn’t implement PM-JAY seem to be losing out on the scheme’s benefits which have accrued to those which have implemented it.

Infant mortality rates and Under-5 mortality declined by 12 per cent and 14 per cent respectively in states which did not implement PM-JAY while they fell by 20 per cent and 19 per cent in states which adopted it.

The states which that did not implement PM-JAY saw a 15 per cent decline in unmet need for spacing between consecutive children while the same for the states that adopted it witnessed a 31 per cent decline - a stark difference.

The states like West Bengal, Odisha, Telangana and Delhi which decided to boycott PM-JAY had raised many doubts over the need of the health insurance scheme of the central government but the data analysis presented by the Economic Survey proves conclusively that the people in these states would’ve been better off had they shed scepticism and adopted the scheme. It’s time that these four state governments realised their mistake. They aren’t hurting anyone but their own people.