Queen Margaret University Reports Findings in Health Policy and Planning (The genesis of the PM-JAY health insurance scheme in India: technical and political elements influencing a national reform towards universal health coverage): Health and Medicine – Health Policy and Planning

2023 JUL 24 (NewsRx) -- By a News Reporter-Staff News Editor at Politics, Law & Government Daily -- New research on Health and Medicine - Health Policy and Planning is the subject of a report. According to news reporting originating in Edinburgh, United Kingdom, by NewsRx journalists, research stated, “Many countries are using health insurance to advance progress towards universal health coverage (UHC). India launched the Pradhan Mantri Jan Arogya Yojana (PM-JAY) health insurance scheme in 2018.”

Financial supporters for this research include Indo-German Social Security Programme, Deutsche Gesellschaft fur Internationale Zusammenarbeit GmbH, Bill & Melinda Gates Foundation, German Federal Ministry for Economic Cooperation and Development, Indo-German Social Security Programme, Deutsche Gesellschaft fur Internationale Zusammenarbeit GmbH, Bill & Melinda Gates Foundation, German Federal Ministry for Economic Cooperation and Development.

The news reporters obtained a quote from the research from Queen Margaret University, “We examine the political economy context around PM-JAY policy formulation, by examining the perspectives of policy stakeholders shaping decisions around the reform. More specifically, we focus on early policy design at the central (national) level. We use a framework on the politics of UHC reform proposed by Fox and Reich (The politics of universal health coverage in low- and middle-income countries: A framework for evaluation and action. J. Health Polit. Policy Law 2015;40:1023-1060), to categorize the reform into phases and examine the interactions between actors, institutions, interests, ideas and ideology which shaped reform decisions. We interviewed 15 respondents in Delhi between February and April 2019, who were either closely associated with the reform process or subject experts. The ruling centre-right government introduced PM-JAY shortly before national elections, drawing upon policy legacies from prior and state insurance schemes. Empowered policy entrepreneurs within the government focused discourse around ideas of UHC and strategic purchasing, and engaged in institution building leading to the creation of the National Health Authority and State Health Agencies through policy directives, thereby expanding state infrastructural and institutional power for insurance implementation. Indian state inputs were incorporated in scheme design features like mode of implementation, benefit package and provider network, while features like the coverage amount, portability of benefits and branding strategy were more centrally driven. These balanced negotiations opened up political space for a cohesive, central narrative of the reform and facilitated adoption. Our analysis shows that the PM-JAY reform focused on bureaucratic rather than ideological elements and that technical compromises and adjustments accommodating the interests of states enabled the political success of policy formulation.”

According to the news reporters, the research concluded: “Appreciating these politics, power and structural issues shaping PM-JAY institutional design will be important to understand how PM-JAY is implemented and how it advances UHC in India.”

This research has been peer-reviewed.

For more information on this research see: The genesis of the PM-JAY health insurance scheme in India: technical and political elements influencing a national reform towards universal health coverage. Health Policy and Planning, 2023. Health Policy and Planning can be contacted at: Oxford Univ Press, Great Clarendon St, Oxford OX2 6DP, England. (Oxford University Press - http://www.oup.com/; Health Policy and Planning - heapol.oxfordjournals.org)

Our news correspondents report that additional information may be obtained by contacting M. P. Bertone, Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland EH21 6UU, UK. Additional authors for this research include S. Srivastava, D. Parmar, C. Walsh and M. De Allegri.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1093/heapol/czad045. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

The publisher of the journal Health Policy and Planning can be contacted at: Oxford Univ Press, Great Clarendon St, Oxford OX2 6DP, England.

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