The Ayushman Bharat scheme, aimed at providing free or low-cost healthcare to millions of low-income families across India, has emerged as a lifeline for many. However, in Guwahati, the experience of availing the scheme’s benefits is far from pleasant
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Ayushman Bharat, which consists of two parts — Ayushman Arogya Mandir, a network of 150,000 health centres offering primary healthcare, and the Pradhan Mantri Jan Arogya Yojana (PM-JAY), offering Rs 5 lakh in annual health coverage per family — is facing multiple challenges in implementation.
Despite the government's claims of widespread benefits under the scheme, ground realities suggest otherwise, particularly in Guwahati, where patients, hospitals, and officials face numerous hurdles.
For many low-income families in Guwahati, availing Ayushman Bharat’s health coverage has become an uphill battle. The scheme promises Rs 5 lakh per family per year for secondary and tertiary care hospitalisations, but many eligible families report difficulties in accessing these benefits.
Speaking to GPlus, a 58-year-old man, a father of four said, "We could not use the benefits of the scheme despite having the card. We have been trying to get treatment for my wife, but the hospital keeps delaying and asking for more paperwork. It’s been months, and we are losing hope."
This is not an isolated case. Many beneficiaries have expressed similar concerns, with long waiting periods, bureaucratic hurdles, and confusion over which treatments are covered under the scheme being common complaints.
While the scheme promises cashless healthcare for beneficiaries, hospitals, particularly government institutions, are facing significant delays in getting reimbursement from the state government. This delay has created a ripple effect, making it difficult for hospitals to continue offering services under Ayushman Bharat.
Talking to GPlus, an official from a prominent government hospital in Guwahati shared the challenges they face. "The funds are released by the state government through the Atal Amrit Abhiyan. But there are significant delays. Sometimes half of our payments are pending for months. Since we are a government hospital, most of our patients use the Ayushman Bharat card. When our bills are pending, we are forced to deny patients because we cannot afford to cover the costs ourselves. But we have received two installments."
Another official from a government superspecialty hospital confirmed the issue: "While it is a continuous process, there is always a delay in receiving the funds from the state. We do our best to keep providing services, but it’s becoming increasingly difficult."
One of the most shocking examples of the challenges faced under the Ayushman Bharat scheme was the temporary suspension of cancer treatment at the B Borooah Cancer Institute (BBCI) in Guwahati. Earlier this year, the institute was forced to halt treatments under the scheme due to insufficient funds.
Despite Chief Minister Himanta Biswa Sarma's assurances of free treatment for cancer patients under Ayushman Bharat-PM JAY, the situation at BBCI told a different story. An official from the institute, speaking anonymously, revealed, "The government has been stalling the payment of our dues for a long time. We simply cannot afford to keep providing treatment when more than Rs 20 crore is still pending. We had no choice but to suspend treatment under the scheme to avoid financial collapse."
The suspension caused distress for many families relying on the scheme for cancer treatment. A family member of a patient shared their concerns: "We were completely unprepared. The cost of cancer treatment is too high for us. Without Ayushman Bharat, we are stuck. It’s impossible to arrange the money overnight."
Following media reports and public outcry, the cancer institute eventually resumed services under Ayushman Bharat, but the incident highlighted the fragility of the system and the heavy dependence on timely fund release.
While government hospitals struggle with delayed payments and heavy patient inflows, the scenario in private hospitals is somewhat different. In Guwahati, not many patients opt for treatment under the Ayushman Bharat scheme in private hospitals. Moreover, only a limited number of treatment packages are available in these hospitals under the scheme.
Talkkng to GPlus, an official from a private superspecialty hospital in Guwahati said, "We receive about 20-25 patients under the Ayushman Bharat scheme each month. It’s not a significant number, but the issue lies in the reimbursement. The government offers very low rates for treatments, and it’s not feasible for us to cover all procedures under the scheme. For instance, if a treatment costs Rs 1000, we might only receive Rs 100 under the scheme, which would result in a loss. So, we only cover a few packages under Ayushman Bharat."
The limited coverage of treatments in private hospitals under the scheme has left many beneficiaries disappointed. Those seeking specialised care are often forced to turn to government hospitals, which are already overwhelmed.
Despite the challenges faced by beneficiaries and hospitals, officials from the Atal Amrit Abhiyan Society, which oversees the implementation of the scheme in Assam, have a more optimistic view. A senior official from the society told GPlus that the government has released significant funds to both government and private hospitals under Ayushman Bharat.
"This financial year, over Rs 250 crore has been released to hospitals across Assam," the official said. "We have more than 60 lakh registered beneficiaries in Assam under Ayushman Bharat, and there are 1949 treatment packages available in government hospitals and 303 packages in private hospitals."
The official acknowledged that there have been delays in fund disbursement but attributed this to administrative issues. "It’s a continuous process. Sometimes the delay happens because hospitals do not submit their bills on time, or they register treatments that are not covered under the scheme. These issues cause delays, but we are working to resolve them."
While the scheme has undoubtedly provided access to healthcare for millions of families, the ongoing issues with fund disbursement, treatment coverage, and hospital infrastructure highlight the need for reforms.
For government hospitals, which serve the bulk of the beneficiaries, the scheme has become both a lifeline and a burden. The influx of patients using Ayushman Bharat cards has put immense pressure on these institutions, especially when funds are delayed. On the other hand, private hospitals, constrained by the low reimbursement rates and limited package offerings, have been unable to fully participate in the scheme.
Will the government address the delays in making reimbursements that are harming both public and private hospitals? Can beneficiaries hope for smoother access to treatment without bureaucratic red tape? And how long will it take to reform the system to truly provide the free healthcare it promises? For now, patients and hospitals alike are left navigating an uncertain path, waiting for solutions that may shape the future of healthcare in the region.