Under the garb of the Ayushman Bharat scheme, here's how private hospitals are overcharging

Did you know that private hospitals are overcharging under government’s Ayushman Bharat health insurance schemes? Read on to find out more.

Under the garb of the Ayushman Bharat scheme, here's how private hospitals are overcharging

Massive gaps in treatment charges have been found at private and government hospitals under the Ayushman Bharat health insurance scheme. Sometimes, the hike observed in treatment costs is over 200%. The initiative was launched by the government to ensure that the people from economically backward strata of society got the medical attention they needed. Under this scheme, free health cover of Rs 5 lakh was promised to 50 crore citizens. More than 18,550 hospitals (54% private, 46% government) were empanelled for the same.

Related: Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana: What You Need To Know

What is the discrepancy?

The government had fixed the cost of healthcare packages under the scheme. However, it was observed that private hospitals charges were substantially more than government hospitals. A preliminary enquiry into neonatal care packages across various states revealed that private hospitals were charging more than three times the usual amount. Even the most basic neonatal care was more than double, as per a report by The Economic Times. 

It was found that the average stay of patients in private hospitals was considerably longer. Also, the packages used were costlier and specialised even when there was no justified need for the same. On the other hand, public hospitals used basic packages.

An official explained that the cost of the treatment depends on the package chosen by health professionals. The cost of treatment increases sizeably as the package becomes heavier. increases. While public hospitals choose packages that cost Rs 500 per day, private hospitals block advanced, critical packages that can cost anywhere between Rs 3,000 and Rs 7,000.

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Cause of concern

While the cost of treatment itself is a red flag, what is adding to the concern is that private hospitals cater to more than 60% of beneficiaries under this scheme. Over 50 lakh patients have utilised the health insurance coverage in the first year of its launch.

It is critical for the government to look into the treatment costs disparity to ensure costs are regulated, resources are not misused, and the welfare scheme is not abused.

Related: 5 Things to know about Ayushman Bharat Health Insurance Scheme

The National Health Authority has been given the responsibility to validate the reasons behind costlier packages. Additionally, they are to formulate stringent guidelines which private hospitals must follow. The government is hoping this will deter private institutions from misusing resources, overbilling the Ayushman Bharat health insurance initiative and ensuring that the right care is provided to recipients. Take a look at this guide to health insurance and get all your insurance-related questions answered.


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