Disruption of healthcare services under the Ayushman Bharat scheme in Jammu and Kashmir has exposed the fragility of a system that was meant to guarantee universal access. A payment backlog of Rs 650 crore has left hospitals and suppliers unable to function, forcing patients to bear costs that the scheme was designed to eliminate. This is not an isolated incident but part of a recurring cycle of delays, unresolved claims and broken supply chains that have repeatedly stalled critical services.
The balance between financial management and service delivery has tilted dangerously. Hospitals cannot continue to provide care without timely reimbursements, and suppliers cannot extend credit indefinitely. When claims remain stuck for months and funds are recalled without visible relief, the credibility of the scheme erodes. Patients who should have been protected are now compelled to pay out-of-pocket for essential implants and procedures, undermining the very purpose of the program.
The crisis further reveals the vulnerability of government hospitals, which are dependent on timely supplies of critical devices. With vendors halting deliveries of pacemakers and other implants, patients are being forced to purchase them privately at unaffordable prices. This shift not only burdens families but also widens inequality in access to healthcare, as only those with financial means can secure treatment. The very institutions meant to serve the poorest are left unable to deliver basic care.
Private hospitals, too, are withdrawing from the scheme, restricting services to minor procedures and refusing complex cases. Their warnings of a complete pullout if dues are not cleared within a month underline the urgency of the situation. If these facilities exist, the already strained public system will be overwhelmed, leaving patients with no viable options. The withdrawal of private participation would effectively dismantle the network of care that the scheme was built upon.
The recurring stoppages of cardiac services in Jammu last year, when suppliers suspended deliveries due to unpaid dues, serve as a reminder that this is not a new problem. The recall of unspent SEHAT funds earlier this year was projected as a corrective measure, but the absence of visible relief underscores the lack of accountability in fund management. Claims remain stuck in processing stages for months, leaving hospitals unable to function. The escalation of grievances to the national authority reflects the desperation of providers who have exhausted all local avenues. Without strict enforcement of protocols and transparent adjudication, the scheme risks total breakdown in the Union Territory.
The crisis also points to the need for structural reforms in the way health financing is managed. A scheme of this scale cannot depend on ad hoc transfers or discretionary approvals. Automatic settlement protocols, backed by a transparent digital dashboard, must be instituted to guarantee timely reimbursements. Hospitals and suppliers should be able to track claim status in real time, reducing uncertainty and restoring trust. A grievance redressal mechanism with binding timelines is essential to prevent claims from stagnating. Responsibility for lapses must be clearly assigned, and accountability enforced at every level.
Clearing pending liabilities within a fixed timeline must be the first step. A transparent claim-tracking system should be introduced to ensure accountability and visibility for hospitals and suppliers. A grievance mechanism with binding timelines is essential to prevent claims from stagnating. Automatic settlement protocols must replace discretionary delays, and responsibility for lapses must be clearly assigned. Without these measures, the scheme risks collapse in practice, leaving both public and private institutions unable to sustain operations.
