Hospitals to be an industry under Ayushman Bharat

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The present government has announced plans to make hospitals into an “industry” under the Ayushman Bharat health insurance scheme and also give help to private hospitals such as land and funding. The government has issued broad guidelines for private investments into setting up hospitals in Tier 2 and Tier 3 cities. Three categories of hospitals have been defined under these guidelines:

  • Model I: Doctor owner (30-50 beds)
  • Model II: Doctor manager partnership-Multispecialty (100 beds)
  • Model III: Multispecialty (100 or more beds)

The government will incentivise setting up of private hospitals like allotting unencumbered land to private hospitals on lease or through bidding, providing funding for projects which are deemed unviable by the private sector and speeding up clearances through special windows with specific timelines, compulsory empanelment of the hospitals for PMJAY and other Government schemes and ensure timely payments for services.

In order for the government to provide this funding to private hospitals under ‘Viability Gap Funding’ (VGF), the hospitals would now be classified as an “industry”.

VGF is essentially a capital subsidy, which the government can provide to project bidders and often, the bidder who asks for the lowest gap funding may clinch the project. The government will provide VGF for private hospitals up to 40% of the total cost of the project, and will also provide gap funding of up to 50% of tax on capital cost.

The private sector has the responsibility to “build, design, finance, manage, operate and maintain with quality standards” these hospitals.

In November last year, the Centre sent a note to all states asking them to sanction loans at agricultural rates of interest and provide electricity at residential rates, to these private hospitals. They want private hospitals to come up in Tier 2 and Tier 3 cities.

In July, the NITI Aayog proposed a model to all states to privatise urban health care – offering private players the chance to capture beds and patients who come to government district hospitals – for the treatment of non-communicable diseases. Private players were being offered this access for a 30 year lease.

The NITI Aayog has also framed guidelines for this PPP model in district hospitals.

So far, private hospitals and medical colleges have worked largely on a “trust model”, wherein a trust owns the hospital or a company manages the hospital via the trust.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Fat around the abdomen detrimental to life in the long run

Health Care, Heart Care Foundation of India, Medicine Comments Off

Physical activity and healthy eating habits are an imperative with increasing age

Look that you are not suffering from wheat belly

New Delhi, 13th January 2019: Excess belly fat can probably shrink the grey matter volume in your brain, according to a new study. Grey matter contains most of the brain’s 100 billion nerve cells, while the white matter is filled with nerve fibres that connect the brain regions. Excess weight was associated with shrinkage in specific regions of the brain: the pallidum, nucleus accumbens, putamen (linked only to a higher BMI) and caudate (linked only to a higher waist-to-hip ratio). All these brain regions are involved in motivation and reward.

Increasing central adiposity is associated with an increased risk of morbidity and mortality. Therefore, in addition to measuring body mass index, waist circumference should be measured to assess abdominal obesity. Patients with abdominal obesity (also called central adiposity, visceral, android, or male-type obesity) are at increased risk for heart disease, diabetes, hypertension, and dyslipidemia.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Normal weight obesity is the new epidemic in our country. One of the primary reasons for this is the lifestyle people lead today. On-the-go and fast-paced lives mean people skip their breakfast and end up eating unhealthy, quick-fix refined carbs meals through the remainder of a day. An extra inch of fat around the abdomen can increase the chances of heart disease by 1.5 times. An abdominal girth of more than 90 cm in men and 80 cm in women is an indication that a person is vulnerable to future heart attacks. One should not gain weight of more than 5 kg after the age of 20 in males and 18 in females. It is also imperative to monitor one’s weight and reduce it appropriately after the age of 50.”

Once a person’s height stops increasing, his/her organs stop growing and only muscles can build up to an extent. The deposition of fat is the only cause that increases the weight of the body after that stage.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “People who are obese should aim at limiting the intake of refined carbohydrates as they tend to increase blood sugar levels and the production of insulin. In those with insulin resistance, this surge can lead to further weight gain. Apart from this, aim at getting about 30 to 45 minutes of physical activity every day, five times a week.”

Some tips from HCFI

  • Exercise every day and consume a healthy diet, a mix of all seven colours and six tastes.
  • Do not consume refined sugar in any form as this can get absorbed into the blood stream more easily and cause further complications.
  • Reduce stress through activities such as meditation and yoga.
  • Skip one food item every day so that the food antigenicity is taken care off
  • If you are wheat sensitive ( not wheat allergic) you may end up with wheat belly and may require ti omit wheat from the diet