MMSY:
Between Promise and Proof
By:
Rattandeep Singh & KPS Maan
(Students of Legal Studies)
When the Punjab government announced the Mukh Mantri Sehat Yojana (MMSY), the promise was simple and seductive: no Punjabi should fear illness because of money. ₹10 lakh per family. Cashless treatment. Universal coverage. For an universal scenario where medical emergencies routinely push families into debt, the announcement felt like relief.
But healthcare policy
is not tested on banners or in press conferences. It is tested in hospital
corridors—at midnight, when a family waits outside an ICU, when a patient needs
urgent admission, when a hospital quietly says, “Approval pending,” or worse,
“Please arrange funds.”
That is where MMSY must work
On paper, the scheme is ambitious. It promises ₹10 lakh per family annually, covers over 2,300 medical procedures, and empanels nearly 900 hospitals. Yet numbers alone do not treat patients—systems are the ones that can accomplish the conducts. MMSY relies on a hybrid financing model where only about ₹1 lakh is insured, while the remaining liability rests directly on the Punjab government. This would be challenging even for a fiscally strong state. Punjab is not one.
Punjab already carries a public debt of ₹3.8–4.2 lakh crore, nearly 47% of its GSDP. Over 40% of state revenues are consumed by fixed obligations like interest payments, salaries, and pensions. This leaves little room for absorbing open-ended healthcare liabilities. Even a conservative scenario shows the risk: if just 10% of Punjab’s 65 lakh families require high-cost treatment averaging ₹3 lakh—a routine figure for cardiac surgery, cancer care, or ICU stays—the state faces a liability of nearly ₹1,950 crore in a single year. At higher utilisation, the burden escalates rapidly.
This is not hypothetical fear; it is basic arithmetic. Moreover, this issue is not just about money; it is about constitutional responsibility. The Supreme Court has repeatedly held that the right to life under Article 21 includes the right to timely medical care and human dignity. Welfare schemes like MMSY draw their moral force from the Directive Principles, especially Articles 38 and 47, which require the State to improve public health. But constitutional duties are not fulfilled by announcements alone. If access to treatment depends on delayed approvals, hospital discretion, or uncertain funding, the right to healthcare becomes fragile. A right that fails in an emergency is not a constitutional guarantee—it is only an administrative promise. MMSY, therefore, must be judged not by what it claims, but by whether its design can actually meet the standard that Article 21 demands.
Experience from earlier schemes like Ayushman Bharat shows what happens next. Hospitals selectively comply. Beds become “unavailable.” Complications fall outside packages. Families are asked to pay despite holding valid cards. As of 2026 over 1,114 hospitals were de-empanelled, 1,504 hospitals were penalised with a total fine of ₹122 crore and approximately 549 hospitals were suspended due to fraudulent activities under PM-JAY for fraud and denial of services. MMSY operates within the same hospital ecosystem, with the same incentives and similarly weak enforcement.
The government claims coverage of hundreds of diseases, yet no consolidated, publicly accessible list of covered procedures, package rates, or exclusions exists. Minor treatments are usually accommodated; high-cost, life-saving care is where friction begins. When details are unclear, discretion shifts to hospitals—and discretion rarely favours the patient.
Grievance mechanisms exist, but mostly after harm is done. When a patient is gasping for breath, portals and helplines are irrelevant. Rights that cannot be enforced in real time are not rights; they are paperwork.
None of this means universal healthcare is a bad idea. It means MMSY may be the wrong execution. Punjab might have been better served by strengthening government hospitals—adding CT and MRI facilities, expanding ICUs, hiring specialists, and restoring public trust in state healthcare—rather than routing scarce public funds into private systems that resist accountability.
MMSY offers hope, and hope matters. But hope unsupported by fiscal depth and enforcement capacity can become cruelty. Healthcare policy should reduce uncertainty, not redistribute it to families at their most vulnerable moments. If MMSY succeeds, Punjab will benefit enormously. If it fails, the cost will not be political—it will be human. Given Punjab’s debt, administrative constraints, and the timing of the announcement, the scheme’s success remains uncertain.
And when illness
strikes, uncertainty is the last thing a family can afford — least of all from
a State constitutionally bound to protect life and dignity.
References:
https://indianexpress.com/article/cities/chandigarh/mukh-mantri-sehat-yojana-punjab-medical-cover-10491908/
https://www.hindustantimes.com/cities/chandigarh-news/cashstrapped-punjab-to-seek-over-12-000-crore-fromrbi-101767466753801.html
https://www.thehindu.com/news/national/punjab/punjabs-rising-debt-raises-concern-amid-claims-of-sound-fiscal-management/article69861644.ece
https://www.researchgate.net/post/Corruption_and_Unethical_Practices_in_Indias_Healthcare_Sector_An_Evidence-Based_Review
https://www.indiacode.nic.in/bitstream/123456789/19150/1/constitution_of_india.pdf
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