The Ayushman Bharat Yojana, a flagship scheme by the central government aimed at providing health insurance to India’s economically weaker sections, has been adopted by most states. However, two significant states – Delhi and West Bengal – have chosen not to implement the scheme, citing various reasons. Both the Delhi government, led by the Aam Aadmi Party (AAP), and the West Bengal government under Chief Minister Mamata Banerjee argue that they have their effective healthcare solutions in place, making Ayushman Bharat unnecessary in their regions.
This choice has sparked debate, especially with the central government alleging that political interests may be behind their decision to stay away from this program. Here’s a closer look at why Delhi and West Bengal have opted out, what they argue, and the alternative healthcare schemes they offer to their residents.
Why Delhi’s AAP Government Has Not Adopted Ayushman Bharat
Delhi’s Aam Aadmi Party (AAP) government, led by Chief Minister Arvind Kejriwal, has decided to opt out of Ayushman Bharat, asserting that the capital’s healthcare initiatives are already fulfilling the needs of its citizens. Here are the key reasons the Delhi government has given:
- Existing Healthcare Programs in Delhi
The AAP government highlights that Delhi has well-functioning healthcare initiatives. According to Delhi government officials, these programs are effective and benefit Delhi’s residents more directly than Ayushman Bharat could. Initiatives like Mohalla Clinics, polyclinics, and revamped public hospitals are already serving a broad segment of Delhi’s population, providing accessible and affordable healthcare. - Concerns Over Ayushman Bharat’s Database
Saurabh Bhardwaj, a minister in the Delhi government, has pointed to irregularities highlighted by the Comptroller and Auditor General of India (CAG) in Ayushman Bharat’s database. Issues such as incorrect names, fake dates of birth, duplicate health cards, and ghost beneficiaries have raised concerns in Delhi about the scheme’s efficiency and authenticity. - Additional Patient Burden from Neighboring States
Delhi’s hospitals cater not only to residents but also to a significant number of patients from nearby states like Uttar Pradesh, Haryana, and Rajasthan, where Ayushman Bharat is already operational. As a result, Delhi’s government argues that the healthcare demand from Ayushman Bharat beneficiaries is already being fulfilled indirectly in the capital. - Skepticism Over Claims
Delhi’s government claims that the practical impact of Ayushman Bharat has not met its proposed targets and that the existing healthcare system in Delhi is better suited to meet the unique needs of the capital’s residents.
Mamata Banerjee’s Reasons for Not Implementing Ayushman Bharat in West Bengal
West Bengal’s Chief Minister, Mamata Banerjee, has also chosen not to implement the Ayushman Bharat scheme, citing her own government’s health program, which she believes serves the state’s residents more effectively. The reasons provided by the Bengal government include:
- The Swasthya Sathi Scheme
West Bengal has introduced the Swasthya Sathi scheme, which provides free health coverage of up to Rs. 5 lakh per family annually for secondary and tertiary care. Mamata Banerjee claims that this scheme is tailored to West Bengal’s needs, and thus there is no need for an additional scheme like Ayushman Bharat. - State Autonomy and Identity
The Mamata Banerjee-led government has emphasized the importance of state autonomy in deciding its policies and programs. Her administration has frequently clashed with the central government over various issues, and Ayushman Bharat’s rejection is also seen as part of this ongoing tension. Banerjee has argued that the Bengal government should have the freedom to implement healthcare programs that best suit its people, rather than adopting central schemes. - Political Allegations and Tensions with the Centre
The central government has suggested that political rivalry may be one of the reasons Bengal has opted out of Ayushman Bharat. However, Banerjee maintains that her decision is based purely on policy preferences and practical considerations. - Ensuring Benefits for State Residents Only
Similar to Delhi, the Bengal government prefers to focus its resources on state residents. With Swasthya Sathi catering specifically to people within West Bengal, Mamata Banerjee believes that her state’s healthcare infrastructure can serve its population adequately without Ayushman Bharat’s involvement.
The Alternatives: How Delhi and Bengal’s Schemes Compare to Ayushman Bharat
While Ayushman Bharat promises free health insurance coverage to economically weaker sections across the country, Delhi and West Bengal argue that their local programs are more suited to the specific healthcare needs of their populations. Here’s a comparison of Ayushman Bharat with the respective schemes in Delhi and West Bengal:
- Ayushman Bharat: Provides up to Rs. 5 lakh per family annually for secondary and tertiary care, focused on covering underprivileged households across the country.
- Delhi’s Healthcare System: Focuses on accessible healthcare for all residents through Mohalla Clinics, free essential medicines, diagnostic tests, and enhanced hospital infrastructure.
- West Bengal’s Swasthya Sathi: Offers Rs. 5 lakh health insurance per family annually, targeting secondary and tertiary care for residents of West Bengal, with coverage across a wide network of hospitals.
Both Delhi and West Bengal argue that their health schemes cover their populations effectively, without the need for Ayushman Bharat. The central government, however, continues to advocate for a unified, national approach to healthcare access, to benefit the widest range of citizens.
While Ayushman Bharat has undoubtedly benefited millions across other states, the decisions by Delhi and Bengal highlight the complexities and debates surrounding centralized versus localized health policies in India.
