The restructuring of the AB-PMJAY-Sehat scheme by the State Health Agency has sparked significant concern among private healthcare stakeholders. The removal of the additional 10% package price for private hospitals and the restriction of four commonly sought surgical procedures to public hospitals have led to an immediate fallout, with private hospitals announcing their withdrawal from the scheme. While the SHA argues that these changes align with decisions made in governing council meetings, the practical implications on healthcare accessibility cannot be ignored. The move to standardise package rates under HBP 2.2 and eliminate the additional payment to private hospitals is, on paper, an attempt to ensure uniformity in pricing. However, private hospitals operate under different financial models. Unlike Government hospitals, which receive state funding for infrastructure, salaries, and operational costs, private hospitals rely on patient revenue for sustainability. The 10% additional package price was an incentive that helped them maintain service quality under the scheme. Its abrupt removal raises legitimate concerns about the viability of continued participation by private hospitals.
Moreover, the exclusive reservation of procedures such as appendectomy, cholecystectomy, haemorrhoidectomy, and fissure-in-ano for public hospitals is another contentious issue. These are common surgical procedures, and restricting them to Government hospitals could create an overwhelming burden on public healthcare facilities, leading to longer wait times and reduced efficiency. J&K’s public hospitals are already struggling with high patient loads and infrastructural limitations. Instead of improving service delivery, this move may result in delays, forcing patients to seek care outside the scheme, defeating its very purpose.
The concerns of private hospital administrators should not be dismissed lightly. Their decision to halt services under the scheme is also about ensuring quality healthcare without compromising on resources. Additionally, the complaint regarding unpaid Government dues adds another layer to the crisis. If payments to private hospitals remain pending, their ability to operate under the scheme is further weakened. The Government must engage with private healthcare stakeholders to find a middle ground. An inclusive approach will ensure that the people of J&K continue to receive uninterrupted and high-quality healthcare under the scheme.
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