Cannot sign away Punjab's interests, Centre must address my concerns first, says Brahm Mohindra
J-K, HP, Uttarakhand, Haryana, Chandigarh ministers sign, Mohindra says no, leaves dais
In a display of political defiance and strong reservations, Punjab has refused to sign the much-touted National Health Protection Scheme, Ayushman Bharat, even as other states went ahead and inked an understanding with the Centre.
With the Union Health Minister, J P Nadda, launching the scheme at Shimla on May 14, Monday, Himachal Pradesh Chief Minister Jai Ram Thakur and his Uttarakhand counterpart T S Rawat put their signatures but Punjab Health Minister Brahm Mohindra dug in his heels and refused to sign it.
Brahm Mohindra was among a galaxy of political leaders attending the workshop at Shimla. As the health ministers from Uttarakhand, Jammu and Kashmir, Haryana, Himachal Pradesh and officials from the Union Territory of Chandigarh went along Narendra Modi's dream project, Mohindra chose to convey it to Nadda in no uncertain terms that the Punjab government would rather wait till its concerns about certain modalities of the scheme are addressed.
"We have some reservations. Punjab already has some health insurance schemes and we are yet to study how those will converge or dovetail with this scheme proposed by the Centre. Besides, we also have certain issues about the Centre-State funding share ratio of 60:40," Brahm Mohindra told Punjab Today.
"Effectively, the current terms mean that my share in the scheme will not remain limited to 40% while the Centre’s liability will stay fixed at 60%. That hardly seems justified. I am here to safeguard the interests of my people and my government." — Brahm Mohindra
The minister said while the Centre plans to release its 60% share, it still has to compute and convey that figure to the states. The worry is that the Union Government will not contribute 60% of the actual premium rate achieved through the open tendering process carried out by the state.
Punjab may be left in a situation where the state government will have to pay in entirety the premium over and above this national ceiling limit determined by the Centre.
"Effectively, this would mean that my share in the scheme will not remain limited to 40% but will rather be open-ended. On top of it, this liability will be driven by the actual premium rates that will emerge from the tendering process, while the Centre’s liability will stay fixed at 60% of the pre-determined ceiling rates that the Centre will decide on its own. That hardly seems justified to me, and I am here to safeguard the interests of my people and my government," Mohindra told Punjab Today.
Also, the minister said while the Centre has agreed to share the administrative expenses of the State Health Agency, it remained silent about sharing the administrative cost of hiring a huge workforce of Ayushman Mitras. These Ayushman Mitras need to be appointed in all empanelled hospitals in Punjab.
Mohindra said while the Centre plans to release its 60% share, it still has to compute and convey that figure to the states. The worry is that it will not contribute 60% of the actual premium rate and will leave states in a lurch.
Mohindra said while certain prescribed package rates have been proposed by the Centre, specific objective factors vary from state to state. "The endemicity, incidence and prevalence of disease pattern, geographic distribution of provider network and manpower availability and economic profile can vary a lot. We will have little flexibility and leverage to revise the rates, and for that too, we will need the prior permission of the government of India," he said.
The minister said he has conveyed all these reservations to the Union Health Minister before he left the stage at the event. Nadda has invited Mohindra to Delhi for discussions to resolve the issue.
"If our concerns are addressed, we will think about the Centre’s offer to sign the MoU, otherwise it will be difficult for us to do so,” he added.
The states that signed the MoU are Himachal Pradesh, Uttarakhand, Haryana and Jammu & Kashmir apart from the union territory of Chandigarh.
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