sudden heart attack? The reputed Health Insurance Companies have included as many as 3000 reputed hospitals in the banned list. The health insurance itself is a big scam.
The Health Insurance Companies will impose several limitations to cashless services. If a person possesses Rs 10 lakh health insurance coverage and already paid Rs 2 lakh for premiums, will be eligible for Rs 56,000 cashless services. The company usually rejects reimbursement and suffers the policy holder in various ways. It will be the duty of the policy holder to pay the premium regularly. That’ s all, there ends the matter. The Health Insurance Protection will be false when a need emerges. Moreover, the health insurance company decides every aspect of the treatment like the hospitalisation, how many days, diagnostic tests, surgical procedures and their methods etc. It will not accept disposable gloves. The companies will appoint a team of doctors with high salaries only to suggest the reasons to reject the hospital bills. This is known to all.
In November 2025, as many as 15,000 corporate hospitals have declared the halt of cash less services of Bajaj Allianz and Care Health Insurance Companies. On the other, the Tata AIG Health Insurance Company has withdrawn its cashless services in all the Max Care hospitals in the country. Thus, the entire corporate health sector has immersed in the scams related to profits. On the other, the people who are distanced from health services have been suffering from diseases. If the same tendency continues, the profit greedy corporate health system will collapse shortly. Government Health Insurance Schemes- Frauds:
It is necessary to strengthen the public health system to ensure the accessibility of health services to all as a right. Contrastingly, the 6 government is destroying public health system and strengthening the insurance- based corporate health care sector. To assure the accessibility of expensive corporate health care to poor, the Central Government has introduced the Rashtriya Swasthya Bima Yojana( RSBY) Health Insurance Scheme in 2008. In view of the low coverage, the out-of-pocket expenditure has increased. Therefore, the scheme is merged in PM- Jan Aarogya Yojana( PM-JAY) which is started in 2018. The government proudly claims that the scheme could provide treatment to 3 crore people and given beneficiary cards to 18 crore people.
In fact, dangerous treatments and surgeries have taken place under this scheme. Thousands of unnecessary hysterectomy surgeries, stents on the pretext of heart disease have been done for insurance money. The scheme has thrown the people’ s health in danger. The hospitals which did not possess minimum infrastructure and medical personnel have been recognised as empanelled under the scheme. The ghost bills became normal. These bills are claimed for unavailable patients and the treatment that is never rendered. This kind of hip replacement case is exposed in Uttarakhand in the audit. Thus, the governments health insurance schemes are filled with scams. The people are denied for the health care services and are made victims for the dangerous treatments and surgeries.
In December 2021, on the issue of frauds of private hospitals under PMJAY, the Union Minister for Health and Family Welfare has informed the Parliament that they have removed 208 private hospitals from the empanelled list of hospitals. Moreover, Rs 16.80 crore penalties are imposed on fraudulent private hospitals. He also gave one important suggestion to the people that they must be conscious about insurance- induced surgeries. All this clearly indicates about the level of frauds in the government health insurance schemes.
On the basis of investigation of the National Health Authority, the Parliamentary Panel on Health Information in March 2025 said that it is necessary to impose penalties on 3200 fraudulent PMJAY hospitals, and 600 hospitals should be suspended and 1113 hospitals should be removed from PM JAY. It, further said that the penalty must be to the tune of Rs 122 crore on the 1,504 deceptive hospitals.
It is a wonder to observe that still, the government in its every annual Union Budget will praise the achievements of PM JAY. However, the people are losing their faith on health insurance policies which will make the survival and development of health insurance companies critical. Therefore, the government in its latest announcement of GST reforms has abolished the 18 percent GST on the health insurance policies. The government is creating an illusion that if people take health insurance policies on a large scale, then the expensive corporate health care will be accessible to them. In fact, prior to announcement of GST abolition on health insurance premiums, the health insurance companies have increased their policy premiums excessively.
The strengthening of profit- greedy health care sector has resulted in the rise of fake doctors. The report of WHO, 2016 states that in India, 57.3 percent of practicing allopathy doctors are fake. The diagnosis, treatment etc. is deceptive. Only the costly and fraudulent corporate health care is in prevalence. In this situation, the poor people are forced to go to fake doctors and fall in danger. Conclusion:
The functioning of corporate hospitals, private health insurance companies and
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Class Struggle