India’s Union Cabinet of Ministers on February 26 cleared an allocation of Rs 1,600 crores for the nation-wide rollout of the Ayushman Bharat Digital Mission (ABDM) over a period of five years, according to a press release. A few days later, in a post-budget webinar on the health sector, Prime Minister Narendra Modi urged more private sector involvement to increase health equity and lauded existing technological interventions in health. The ABDM is the Indian government’s multi-tiered, health digitisation project.
The National Health Authority, leading the ABDM, has also repeatedly stressed greater public-private partnerships for implementing the project with an open, API-based structure so that private players can build solutions on top of it.
Where is private sector involvement needed, according to PM Modi?
In the webinar which was attended by nurses, paramedics, doctors, and other technology and research professionals from both the private and public sector, PM Modi identified three areas of the health sector as crucial:
“Firstly, expansion of infrastructure and human resources related to modern medical science. Secondly, promotion of research in traditional Indian system of medicine like AYUSH and its active engagement in the healthcare system and thirdly, providing better and affordable healthcare facilities to every person and every part of the country through modern and futuristic technology.” — PM Modi
Discuss the scope and impact of CoWIN and ABDM: Claiming that CoWIN (India’s COVID-19 vaccine management platform) is recognised worldwide, Modi said that the emergence of the ABDM would allow global access to Indian health facilities, improve medical tourism, and provide income opportunities. He further asked stakeholders to discuss the scope and impact of these initiatives.
More than 2 crore patients interacted virtually: Over 2.5 crore patients used teleconsults, telemedicine, and remote healthcare during the pandemic, Modi said. Fiber networks are being provided to villages and 5G will also be rolled out soon, he added. Modi asked the private sector to come up with suggestions on how bigger city hospitals could be connected with district level dispensaries and AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) centres, and how teleconsultations could be expanded further.
Ayushman Bharat Digital Mission and concerns around private sector
Under the ABDM which was announced in August 2020, 17 crore Unique Health IDs or Ayushman Bharat Digital Accounts (ABHA) have been issued. Multiple private sector entities like Practo, DRiefcase, PayTM, Apollo hospitals, etc., have been integrated with the project to issue health IDs and handle electronic health records of enrolled citizens.
However, there have been serious concerns about the private sector’s access to health data of citizens under such massive digitisation projects.
In her paper titled “Health Data as Wealth: Understanding Patient Rights in India within a Digital Ecosystem through a Feminist Approach” researcher Radhika Radhakrishnan, found that rapid digitisation of health could limit insurance coverage for the most vulnerable. Insurance companies could normalise requiring access to data from health trackers, electronic health records, etc., to make decisions about their insurance coverage or premiums. This could take place even in the absence of proof that such practices were effective, she said.
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