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RAN-Ayushman Bharat gap closed in boon for patients

The All India Institute of Medical Sciences in Delhi, where 17-year-old Pankaj died awaiting a bone marrow transplant he could have availed if not for a gap between Ayushman Bharat and RAN. 

Ayushman Bharat beneficiaries will no longer be denied access to treatment under the Rashtriya Arogya Nidhi (RAN), following the intervention of the Union Ministry of Health and Family Welfare concerning a controversial gap between the two initiatives. 

RAN “provides for financial assistance to patients, living below [the] poverty line and who is suffering from major life threatening diseases, to receive medical treatment at any of the super-specialty government hospitals/institutes” according to the Union Health Ministry. However, controversy has erupted over those who would be eligible for RAN being denied coverage because they are also covered under Ayushma Bharat. This has been in the crosshairs of the National Human Rights Commission and the Delhi High Court in recent months – and the controversy was heightened following the death of a seventeen year-old boy earlier this year. 

Pankaj of the Vaishali district of Bihar was affected by aplastic anaemia. As explained by the US-based National Heart, Lung, and Blood Institute, “aplastic anemia is a rare but serious blood disorder that occurs when your bone marrow cannot make enough new blood cells for your body to work normally.” The condition is caused by “damage to stem cells inside bone marrow, which is the sponge-like tissue within your bones. Many diseases and conditions can damage the stem cells in bone marrow. As a result, the bone marrow makes fewer red blood cells, white blood cells, and platelets.”

Aplastic anaemia, if untreated, can have dire ramifications. “Signs and symptoms of aplastic anemia include fatigue, infections that last a long time, and easy bruising or bleeding,” explains the National Institute. “The low levels of blood cells also increase your risk for complications such as bleeding, leukemia, or other serious blood disorders. Without treatment, aplastic anemia can lead to serious medical conditions such as arrhythmia and heart failure.”

Treatments for aplastic anaemia can include bone marrow transplants. Pankaj was awaiting a bone marrow transplant at the time of his death in the All India Institute of Medical Sciences (AIIMS). Because he was listed as a beneficiary of Ayushman Bharat, which does not cover bone marrow transplants, Pankaj was unable to avail the benefits under RAN. Caught between the two schemes, Pankaj lost his life on January 20th – despite RAN offering coverage of Rs 15 lakh, which would have covered the Rs 12 lakh cost of the procedure at AIIMS. 

The Health Ministry has now moved to close the gap. Per a memorandum, “if as per medical advice, the suggested treatment is not covered under any of the approved listed packages of AB-PMJAY, financial assistance up to Rs 15 lakh can be provided to AB-PMJAY beneficiaries out of umbrella scheme of RAN.” 

Tragically, the news comes too late for Pankaj and his family. Closing this loophole, while not taking their loss, can offer some relief to families in similar situations who have been denied treatment thus far. 

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