Flaying the union government's ambitious Ayushman Bharat health insurance,Kerala Finance Minister Thomas Isaac on January 31 said it was a financial burden on the state and quoted from Aesop's fables to describe it as a "mountain giving birth to a mouse".

The phrase suggests that the result or achievement is less than claimed or promised to be. Under the Ayushman Bharat scheme, a cover of Rs. 5 lakh per family would be provided every year to over 10.74 crore poor families for secondary and tertiary care hospitalisation.

Isaac said while the whole credit for the scheme goes to the Centre, it was a 'complete financial burden' on the state government. Comprehensive Health Security Scheme was announced in the previous state budget. But it could not be implemented. It is because, consequent to the announcement of the Ayushman Bharat Scheme of Rs. 5 lakh (per family) in the Central budget, we were waiting for its criteria.

When details of the scheme came out in October, it was like a mountain giving birth to a mouse," Isaac said presenting the state budget for the 2019-20 fiscal. The minister said the premium agreed by the Centre was Rs. 1,250 per person for Rashtriya Swasthya Bima Yojana (RSBY) in which benefits worth Rs. 30,000 are received.

"At the same time, the premium provided for the scheme of Rs. 5 lakh was only Rs. 1,100. Moreover, the Central Government will only provide 60 per cent of this," he said, adding it is estimated that for benefits worth Rs five lakh, the premium will be more than Rs. 8,000 per annum. "Now there are 42 lakh beneficiaries in the RSBY scheme.

Whereas under Ayushman Bharat, the Central Government provides assistance to 18 lakh families only. The total expense for us is around Rs 800-1,000 crore whereas the central assistance is below Rs. 100 crore," he said. Isaac said that there were four components for the Comprehensive Health Security Scheme which was going to be implemented in Kerala by the state governement. "First is, India's best network of Primary Health Centres. Among them, 150 hospitals were upgraded to Family Health Centres.

In the next stage, 200 more hospitals will be upgraded to this status. All Primary Health Centres will be upgraded to Family Health Centres step by step," he said. Isaac said Kerala would become a region in which the Astana Global Health Conference Declaration of primary health services would be implemented in full. "The family health hospitals will have three doctors and proportional para medical staff. Outpatient facility will be available in the afternoon as well.

There will also be a laboratory and pharmacy. Once this scheme becomes universal, the rush in the secondary and tertiary hospitals will be reduced," he said. The Global Conference on Primary Health Care in Astana, Kazakhstan in October 2018 endorsed a new declaration emphasizing the critical role of primary health care around the world. The declaration aims to refocus efforts on primary health care to ensure that everyone everywhere is able to enjoy the highest possible attainable standard of health.