After the introduction of the Pradhan Mantri Jan Arogya Yojana, or PM-JAY Yojana, which covers medical expenses up to five lakhs and authorizes hundreds of hospitals, including private hospitals, to provide specialized medical services to patients, healthcare in Jammu and Kashmir has seen a dramatic improvement. While for the rest of India, the scheme is for people living below the poverty line, as a special case, every citizen of Jammu and Kashmir is entitled to enrol in the scheme, get the Ayushman Bharat card, and avail the benefits. With one stroke, gone are the days of months of tormenting waiting periods in Government hospitals for even minor operations. Information about each hospital empanelled is on the website, and one can easily pick and choose the hospital to avail of medical attention. There is also a feedback mechanism provided by the GoI, as after the hospitalisation and availing of the services, patients do receive calls to check on the authenticity and quality of the services, as well as to ensure no payment is taken from the patient. This PM-JAY scheme has been a blessing in disguise for poor as well as middle-class families who are no longer burdened or stretched financially to avail medical attention. Even in Government hospitals, nurses ensure Ayushman Bharat cardholders get their free medicine deliveries on time. The burden on Government hospitals has reduced a lot except in chronic cases, where it is always better to approach GMC Jammu or another specialised Government hospital for treatment. All diagnostics, from laboratory tests to ultrasound, CT scan, or MRI, are free of charge for hospitalised patients, but for outpatients, these test costs are not covered under the PM-JAY scheme. All said and done, this whole Ayushman Bharat Yojana is a win-win situation for all: patients get proper treatment free of cost, private hospitals get business, and Government hospitals get a bit of relief from their usual rush. But with every Government scheme, conmen also get involved, and this PM-JAY scheme is no exception. Time and again, various private hospitals in Jammu and Kashmir are being penalised for fraudulent claims under PM-JAY. It is a serious matter that few white-coated men are indulging in such malpractices despite taking an oath to serve humanity. This is not the first time that thirteen hospitals have been suspended and penalties worth Rs. 1.77 crores imposed; this has happened in the past also, and some of these hospitals are repeat offenders. There seems to be a constellation of hospitals indulging in such shameful activities.
Taking advantage of patients and committing fraud in medical claims is a completely unacceptable norm, and the LG Administration must impose harsher penalties on repeat offenders; the suspension is insufficient punishment. The good work of administration has not to be dragged down by such incidents. A collegial gravitas action by the Medical Council of India on these heinous activities is also required. Need for more vigilance: sincere hospitals must be rewarded with recommendations on official sites, and defaulter ones must also be mentioned so that future patients know the credibility of these hospitals.
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