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Delays And Problems Are Hurting Ayushman Bharat In Jharkhand

Delays And Problems Are Hurting Ayushman Bharat In Jharkhand

08-06-2025

Context:

  1. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is India’s biggest health insurance scheme.
  2. It is facing serious problems in Jharkhand.
  3. Many hospitals in the state have not received payments for months. Some hospitals have already stopped offering treatment under the scheme.

Key Highlights:

  1. Scheme Launched:
    1. Ayushman Bharat was launched in 2018 . It provides ₹5 lakh per family every year for hospital care.
  2. Coverage:
    1. Around 28 lakh families (1.5 crore people) are covered under Ayushman Bharat in Jharkhand. Another 38 lakh families are covered under the state’s own scheme.
  3. Hospital Network:
    1. About 750 hospitals are registered under the scheme in Jharkhand.
  4. Significance:
    1. Help for Poor Families:
      1. Ayushman Bharat helps poor families in Jharkhand get free hospital treatment.
      2. It covers expensive surgeries and tests so they don’t have to pay from their own pockets.
    2. Biggest Health Insurance in the World:
      1. This is the largest government health insurance scheme in the world. Many families in Jharkhand use it for cashless treatment in hospitals.
    3. Important for Jharkhand:
      1. The scheme started in Jharkhand, so the state gets special focus. Many people know about it and have joined the scheme here.
    4. Helping Women and Children:
      1. Ayushman Bharat helps women and children get the healthcare they need.
      2. It pays for maternity care, child health check-ups, and important treatments.
      3. This has made health better for many women and children in Jharkhand.

Challenges

Way Forward

1. Delayed payments to hospitals, even those not under investigation

Release pending payments to hospitals not flagged for fraud without further delay

2. Hospitals pulling out of the scheme due to financial stress

Provide urgent financial support or advance payments to keep hospitals functional

3. Fraud and misuse (fake beneficiaries, overbilling, etc.)

Speed up ED investigations; punish guilty hospitals without affecting genuine ones

4. Technical issues in HEM 2.0 portal (data missing, slow processing)

Fix and upgrade the portal; provide technical help to hospitals for smooth claim submission

5. First In, First Out (FIFO) system slowing down payments

Allow flexible processing of urgent and high-value claims where needed

6. Lack of communication between government and hospitals

Conduct regular review meetings and feedback sessions with hospital representatives

7. Political blame game delaying resolution

Ensure non-political coordination between Centre and State for effective scheme implementation

8. Pressure from expanding coverage (Rs 15 lakh under state scheme)

Strengthen digital and financial infrastructure before expanding coverage further

Conclusion:

Ayushman Bharat is a vital scheme for poor families, but in Jharkhand, it is facing a serious crisis. Payment delays, technical issues, and fraud probes have disrupted hospital services. Immediate corrective steps are needed to restore trust and ensure smooth functioning. Healthcare for the poor must remain a top priority beyond politics and process delays.

 

Ensure IAS Mains Question:

Q. Discuss the significance of Ayushman Bharat in strengthening India’s public health system. What are the key challenges faced in its implementation across different states?

 

Ensure IAS Prelim MCQ:

Q1. Consider the following statements with respect to the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) in Jharkhand:

  1. Ayushman Bharat was launched in 2018 and provides ₹5 lakh per family annually for hospital care.
     
  2. About 750 hospitals are registered under the scheme in Jharkhand.
     
  3. The scheme covers around 66 lakh families in Jharkhand.
     

How many of the above statements is/are correct?

(A) Only one
(B) Only two
(C) All three
(D) None

Answer: B

Explanation:

  1. Statements 1 and 2 are correct: The scheme was launched in 2018 and provides ₹5 lakh per family annually; about 750 hospitals are registered in Jharkhand.
  2. Statement 3 is not correct: because around 28 lakh families are covered under Ayushman Bharat, and another 38 lakh families under the state’s own scheme, totaling more than 66 lakh families but not all under Ayushman Bharat.

Delays And Problems Are Hurting Ayushman Bharat In Jharkhand

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