India's Five-Lakh Health Card Does Not Pay the Chemist — Epoche B1
India's Ayushman Bharat card promises a family five lakh rupees, five hundred thousand, every year for hospital treatment at an empanelled hospital, meaning one approved by the scheme, and the family pays no premium for it. Hundreds of millions of people are now covered. It is the largest promise of its kind anywhere, and it should be praised before it is questioned. My neighbour tells the story this way. Her mother-in-law fell and broke a hip; they carried the card, the operation was done, and nobody asked for money. Then she adds the second story, the one folded inside the first. The same woman has had diabetes and high blood pressure for eleven years. Every month somebody walks to the chemist and buys the strips, the tablets, the insulin. She was never admitted for that, so nothing was ever claimed. That is the gap, and it is not a detail. Most of what Indian households spend on health out of their own pockets is not a hospital bill at all. It is outpatient consultations, tests and, above all, medicines, paid in small amounts, month after month, for conditions that last for years. Medicines alone make up the largest single share of that spending. A card written for admission cannot see any of it. The answer is not to shrink the cover but to extend the logic. Free medicines for long-term illness at the local health and wellness centre, dispensed near home, would meet the spending where it actually happens. Until then we should be careful with the sentence families keep repeating: we have the card, so we are safe. They are safe from the operation. They are not safe from the chemist's bill. References National Health Authority (2018). Ayushman Bharat Pradhan Mantri Jan Arogya Yojana: Scheme Guidelines. Government of India. National Health Systems Resource Centre (2022). National Health Accounts Estimates for India 2019-20. Ministry of Health and Family Welfare, Government of India.