J&K’s free healthcare on the brink

Srinagar, Aug 3: The Jammu and Kashmir government's ambitious free health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), popularly known as the SEHAT scheme, has hit a major roadblock.

Approximately 150 private hospitals and dialysis centres empanelled under the scheme in J&K have not received payments since March 14, 2024, putting the programme’s smooth functioning at risk.

According to officials, the crisis stems from a legal dispute between the J&K government and IFFCO-TOKIO General Insurance Company Limited, the insurer that unilaterally terminated its three-year contract in November 2023.

The contract, which began on March 10, 2022, was supposed to run until March 14, 2025.

A private hospital owner in Kashmir, speaking on condition of anonymity said, “We are facing a dire situation. The financial crunch will force us to shut down the free service and our hospitals. We don't wish to stop the service given our empathy with patients, but we are forced to consider this due to non-payment of bills since March.”

The hospital owner said, “Our bank loan interest is increasing. We can’t pay salaries to our employees, or settle bills for electricity, water, and medical supplies.”

According to private hospital and dialysis centre owners, the total pending amount is reported to be approximately Rs 226 crore.

Despite multiple attempts to resolve the issue, hospital owners claim their pleas have fallen on deaf ears.

“We held an official meeting with the CEO of the State Health Agency in April 2024 who assured us that the matter would be solved by the first week of May 2024,” another hospital owner said, requesting anonymity. "After the failure to release payments, we applied to the Chief Secretary through the CEO of Ayushman Bharat on May 18, 2024, requesting fund release by May 31, 2024."

He said that on May 31, 2024, the Secretary Health convened an online meeting with all private hospitals and dialysis centres of J&K, assuring them that their money was safe and the matter would be resolved soon.

“Based on this assurance, the hospitals postponed the suspension of medical services,” he said.

A dialysis centre owner, who also wished to remain unnamed, said, “With no resolution in sight, the situation has reached a critical point. We have been continuously providing medical services, keeping in view our responsibilities towards the general public. But now we have reached such a stage where we can't continue our medical services due to bankruptcy."

The AB-PMJAY scheme, which provides free coverage to J&K residents, has been a lifeline for many patients who cannot afford private healthcare. The current impasse threatens to deprive thousands of beneficiaries of essential medical services.

Responding to the crisis, CEO of the State Health Agency (SHA) Sanjiv Gadhkar told Greater Kashmir, "These private hospital owners are fully aware that the reason for non-payment of their bills is a legal issue between the insurance company and government. We are trying our best."