 What does the government do when it fails to give its citizens a good public health care system? It gives them health insurance instead. A health insurance scheme for the poor in India, Ayushman Bharat is promoted as the world's largest free health care scheme. Under this scheme, it's possible to avail free medical treatment up to 5 lakhs per family every year. It's also a paperless scheme and can be availed at both private and public hospitals. On paper, Ayushman Bharat is a good scheme which provides medical support to families in need of health care. Even the stats are impressive. According to the government, more than 11 crore e-cards have been generated to patients. Almost 20,000 hospitals have opted to offer the scheme. But the Ayushman Bharat health insurance scheme has faced major question marks from the very first state. Is this a simple example of Ayushman Bharat and where the money is going? Actually, it's an interesting example because much worse things are also happening under the Ayushman Bharat. But anyway, even if we take this as an example, first of all the question arises, why did a woman for a normal delivery have to go through the Ayushman Bharat to a private hospital? In a developed state like Haryana, primary health centers or other public health facilities should have been easily able to do a normal delivery. That is number one. Number two, even if she went through the Ayushman Bharat program, why did she not get the Jannisurakshaya Yajna benefit? It should have been given. And number three, this 9,000 rupees which was given, I mean, is this kind of a level of payment justified? So actually, if those 9,000 rupees, if half of that amount had been put into a public health facility, they would have done an excellent normal delivery. A lot of hospitals are actually using the scheme to their advantage with many committing fraud as well. Let's take a look at some examples. In Gujarat, 1700 Ayushman Bharat cards were issued just to one family. In Chhattisgarh again, 109 cards were issued to one family out of which 57 cards were used for cataract surgeries. Does that even sound plausible? The next one will shock you and amuse you at the same time. In Jharkhand, one patient was shown as being admitted in two hospitals at the same time. So who benefits from the fraud? The private hospitals and insurance providers, of course. Let's try to understand how exactly does the scheme allow for private hospitals and insurance providers to benefit at the cost of patients. A patient can visit an impaneled hospital and check their eligibility status. An impaneled hospital is a hospital that has registered themselves to offer the Ayushman Bharat scheme. Hospitals then have to submit all the details of the claim to the insurance company within 24 hours of patient discharge. And the onus is on the insurance companies to settle the claims within 15 days. In this model, large insurance companies have become direct beneficiaries of the scheme since they will receive premiums from the government directly. Here are the other problems. More than 2 lakh fake Ayushman Bharat cards have been generated by hospitals. 171 hospitals have been found to have generated fake bills. Most of these claims have already been settled and the money has been transferred to the hospital's bank account. But even before the Ayushman Bharat scheme, private hospitals in India were enjoying a good day. So actually, we cannot understand Ayushman Bharat adequately without understanding the current state of the private healthcare sector in India. And India has one of the most privatised healthcare systems in the world. 60% of inpatient care and 80% of outpatient care is given by private hospitals and private providers. And although it is so huge and dominant, it is almost completely unregulated. And that is a major problem. So we have a large scale violation of patients' rights. Care is often unaffordable. Roughly five and a half crore Indians are pushed below the poverty line every year because they cannot afford medical expenses in private hospitals. 40% of hospitalisation episodes in our country are met by people who have to sell their assets like land or jewellery or take large scale loans. The care is so unaffordable. And irrational care is also quite common, unnecessary caesarean sections, hysterectomies etc. As you must be knowing that data shows that in certain states 50 to 70% of deliveries are being done by cities in section which is grossly in excess of what is medically justified. So it's a highly unregulated sector and it's driven by profit making. A similar scheme was started in 2008 by the UPA government called Rashtriya Swastbhima Yojana RSBY. Under RSBY, only five members of a family were eligible for health insurance but with Ayushman Bharat, that cap has been removed, which in turn allows for the possibility of endless cards for one household. As we saw in Gujarat, 1700 cards were generated by just one household. Hospitals, especially private hospitals, might even misuse the scheme by recommending expensive treatments even if patients don't need it. Instead of improving public healthcare systems and practices in the country, why did the government choose to bring in third parties like health insurance companies? The world's largest free healthcare scheme, Ayushman Bharat, is being used and abused to profit certain private parties. However, the health minister has not yet issued a single statement about all the frauds that are coming out. I guess Mr Modi is setting the trend for all the ministers in his cabinet.