Speaking to TNIE, Dr Rajeev Jayadevan, author of the article and past president of the Indian Medical Association (IMA), Kochi, said, “Many people do not have sufficient health insurance coverage. Therefore, these expenses often require loans that destabilise their financial situation.”“For people living on the margin, this pushes the whole family into poverty, affecting the nutrition, education, and health of other family members. Poverty then becomes a major comorbidity that further worsens health outcomes, creating a vicious cycle.”He said that though the Indian government has launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PM-JAY) to cover the poorest segments, many hospitals avoid these patients, citing low reimbursement rates and significant payment delays.“There is also reported misuse by wealthier people enrolling in these schemes through false declarations, diverting benefits from the truly needy. With about 70% of healthcare provided privately, expanding insurance coverage is crucial to prevent catastrophic expenses. Stronger regulation is needed to prevent unfair claim rejections,” said Dr Jayadevan, who is also Convener Research Cell, Kerala State IMA.
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