Health policy

Story hook

It is 23 September 2018. Prime Minister launches Ayushman Bharat — Pradhan Mantri Jan Arogya Yojana (PMJAY) from Ranchi, Jharkhand. On stage, he calls it the "world's largest government- funded health insurance scheme". The pilot will cover 10.74 crore poorest families (~50 crore beneficiaries) with Rs 5 lakh per family per annum for secondary and tertiary hospitalisation, cashless, portable across states, paperless.

Five months earlier, on 14 April 2018, the Government had launched the second pillar of Ayushman Bharat — Health and Wellness Centres (HWCs) at Jangla, Chhattisgarh, in a Naxal-affected district. The plan: convert 1.5 lakh sub-centres and primary health centres into HWCs offering Comprehensive Primary Healthcare (CPHC) — including non-communicable disease screening, palliative care, mental health, geriatric, and adolescent services.

These two pillars — primary care (HWC) + financial protection (PMJAY) — rest on the architecture of the National Health Policy 2017, which set out India's health vision: universal access to good quality health care services without anyone facing financial hardship. NHP 2017 committed to raising public health spending to 2.5% of GDP by 2025 (still ~2.1% in 2024-25) and to strengthening the public health system.

This unit is about India's evolution from a colonial Bhore Committee 1946 → Health Survey 1961 → NHP 1983 → NHP 2002 → NHP 2017 → Ayushman Bharat 2018 → PM-ABHIM 2021 trajectory — and why, despite all of it, India's out-of-pocket expenditure remains ~47% of total health expenditure.

Why this matters for UPSC

A perennially-tested GS-II topic. Prelims: NHP targets, PMJAY eligibility, HWC services, IPHS standards (asked 2018, 2020, 2022, 2024). Mains: appears almost every year — "evaluate PMJAY" (2019), "NHP 2017 vis-à-vis UHC" (2021), "primary healthcare strengthening" (2024). Interview: dominant probe area given COVID-19 lessons.