31.29 Lakh Cards Issued, ₹988 Crores Spent, but Scheme Faces Criticism for Misuse and Delays

Shimla – The Himachal Pradesh government is preparing to make significant changes to the Himcare scheme following a comprehensive audit that uncovered substantial flaws. This program, designed to provide cashless treatment to residents not covered by the central government’s Ayushman Bharat scheme, has come under scrutiny for mismanagement and inefficiencies.

Since its inception, the HIMCARE scheme has issued 31.29 lakh cards and provided treatment to 7,64,707 patients across Himachal Pradesh. Despite collecting ₹101 crores in premiums, the government has released ₹500 crores towards the scheme, with total expenditures amounting to ₹988 crores. However, an audit conducted by the health department revealed several critical issues.

“There are many flaws in the Himcare scheme. The purpose for which this scheme was implemented is also not being achieved. There is a need for a change from premium to eligibility. A decision will be taken in the cabinet on the instructions of the state government,” said Health Secretary M. Sudha Devi.

The audit exposed that some state government employees, who are also entitled to separate medical reimbursements, were taking undue advantage of the HIMCARE scheme. Additionally, the provision of free diagnostic services under the scheme has been misused, and instances of selective surgeries being performed at private hospitals have been reported. These practices contradict the scheme’s objective of ensuring that no poor patient is denied treatment.

Due to delays in payments after treatment, many private hospitals have stopped accepting HIMCARE cards. Although a recent release of ₹100 crore in April temporarily revived the scheme in major medical colleges, its long-term viability remains uncertain. Initially, the scheme offered cashless facilities in 141 health institutions, including PGI Chandigarh and Sector-32 Hospital outside Himachal Pradesh.

In light of these findings, Health Secretary M. Sudha Devi has prepared a detailed presentation for the Chief Minister, outlining the audit results and proposed reforms. The presentation will be reviewed by the cabinet, which will decide on the future course of action for the Himcare scheme.

The Himachal Pradesh government is at a crucial juncture in ensuring that the HIMCARE scheme effectively serves its intended purpose. The upcoming cabinet decision will be important in addressing the identified flaws and realigning the scheme to better meet the healthcare needs of the state’s underserved population.