Ayushman scheme on verge of collapse in HP

Around 5.32 lakh families registered under the Ayushman Bharat scheme in Himachal Pradesh are in the midst of a health-related scare. The Centre’s scheme, which provides health coverage up to Rs 5 lakh per family to the economically vulnerable section of society, has run into trouble owing to pending payments to the empanelled hospitals.

The pending payments under the scheme have risen to Rs 198 crore. While most private hospitals stopped providing medical care under the scheme long time back, the government hospitals too are struggling to provide cashless treatment, especially to the patients who require expensive medicines or medical equipment.

Sources in the Health Department point out a “flaw” in the scheme that has pushed it to the point of collapse. “The Centre runs this scheme on a 90:10 basis with the state government. However, the Centre has capped its contribution at Rs 50 crore per annum, but the annual expenditure on this scheme is between Rs 110 crore to Rs 115 crore,” said an official. “If the Centre pays Rs 50 crore and the state government gives Rs 5 crore as per the 90:10 arrangement, who will pay the remaining Rs 55 to 60 crore,” the official asked.

The official pointed out that to put the scheme back on track, the state government had been urging the Centre to either enhance its contribution or make the payment on a 90:10 basis on the actual expenditure. “The Chief Minister had raised the issue with Union Health Minister JP Nadda during the Northern Zonal Council meeting held in Faridabad a few days ago,” the official said.

Meanwhile, the fully state-sponsored Himcare health insurance scheme, which provides cashless treatment coverage up to Rs 5 lakh for families not covered under the Ayushman Bharat scheme, is also under a lot of stress. The pending payments under the scheme have risen to Rs 398 crore, and the treatment under this scheme, too, has become uncertain. “A lot of chronically ill patients are able to afford treatment because of these schemes, especially the patients under the Ayushman scheme. These are extremely beneficial schemes, and the governments should try their best to run these smoothly,” said a doctor working at the Indira Gandhi Medical College and Hospital.