The importance of state-supported health schemes cannot be overstated. Each year, around 63 million people fall below the poverty line due to out-of-pocket (OOP) healthcare expenses. Politicizing these support structures undermines their effectiveness. Delhi, for example, maintains a relatively robust health support system, while Bengal’s system, as highlighted by the recent RG Kar episode, appears to be falling apart.
In India’s federal structure, health is primarily a state subject, meaning state governments bear the primary responsibility for healthcare services. However, the Government of India (GoI) also plays a crucial role in policy design and financing.
This shared responsibility often leads to conflicts between states and the Center, exacerbated by political rivalries. Earlier this week, the Prime Minister drew attention to this issue, stating that the “walls of the political profession” prevent elderly citizens in Delhi and West Bengal from benefiting from Ayushman Bharat.
Despite political differences, the data shows Ayushman Bharat is making a difference. Opposition-led states like Tamil Nadu, Karnataka, Kerala, Jharkhand, Punjab, Telangana, and Himachal Pradesh have found value in the scheme, providing critical relief to families grappling with the costs of specialized and life-saving treatments.
While states should maximize the scheme’s potential and avoid politicizing health, Ayushman Bharat does have limitations: limited empaneled hospitals, low coverage (only 56% of the eligible population), varying levels of usage across states, continued high OOP expenses, ground-level corruption, private hospitals' reluctance to fully participate, and data inconsistencies.
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These issues need immediate attention, and solutions will require the GoI and states to collaborate to strengthen healthcare outcomes rather than allow valuable resources to be wasted in political strife.
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