Page 327 - ES 2020-21_Volume-1-2 [28-01-21]

310 Economic Survey 2020-21 Volume 1

CONCLUDING OBSERVATIONS

9.52 The health outcomes of the states that adopted PM-JAY improved when compared to
the states that did not adopt it. Using difference-in-difference computations that control for
confounding factors, this chapter shows that states adopting PM-JAY are able to improve their
health outcomes. Relative to states that did not implement PM-JAY, states that adopted it
experienced greater penetration of health insurance, experienced a reduction in infant and
child mortality rates, realized improved access and utilization of family planning services,
and greater awareness about HIV/AIDS. While some of these effects stemmed directly from
enhanced care enabled by insurance coverage, others represent spillover effects due to the same.
Even though only a short time has elapsed since its introduction, the effects that are identified by
the Survey underscores the potential of the program to significantly alter the health landscape
in the country, especially for the vulnerable sections.

CHAPTER AT A GLANCE

¾ This chapter demonstrates strong positive effects on healthcare outcomes of the Pradhan
Mantri Jan Arogya Yojana (PM-JAY) – the ambitious program launched by Government
of India in 2018 to provide healthcare access to the most vulnerable sections. This is
despite the short time since the introduction of the program.

¾ PM-JAY is being used significantly for high frequency, low cost care such as dialysis
and continued to be utilised without disruption even during the Covid pandemic and the
lockdown. General medicine – the overwhelmingly major clinical specialty accounting
for over half the claims - exhibited a V-shaped recovery after falling during the lockdown
and reached pre-CoVID-19 levels in December 2020.

¾ The final – but the most crucial – analysis in the chapter attempts to estimate the impact of
PM-JAY on health outcomes by undertaking a difference-in-difference analysis. As PM-
JAY was implemented in 2018, health indicators measured by National Family Health
Surveys 4 (in 2015-16) and 5 (in 2019-20) provide before-after data to assess this impact.
To mitigate the impact of various confounding factors that may be contemporaneously
correlated with the adoption of PM-JAY, we compute a difference-in-difference by
comparing states that implemented PM-JAY versus those that did not. We undertake this
analysis in two parts. First, we use West Bengal as the state that did not implement PM-
JAY and compare its neighbouring states that implemented PM-JAY – Bihar, Sikkim
and Assam. Second, we repeat the same analysis for all states that did not implement
PM-JAY vis-à-vis all states that did.