Act by act, the flagship scheme meant to be a lifeline for the poor is on a ventilator itself. The current tally: a staggering Rs 650 crore in unpaid dues, split almost evenly between private hospitals (Rs 350 crore) and Government institutions (Rs 300 crore). It is a systemic collapse, years in the making, dressed up each time as a "temporary hiccup". The plot, by now, is depressingly familiar. Hospitals raise the alarm. Officials promise redressal. A partial payment trickles through - enough to buy silence, never enough to buy solvency. Then the cycle resets. Claims worth crores have been frozen at processing stages since July last year, snarled in adjudication disputes with the insurance partner, while patients pay the price of every unresolved clause. There is talk of litigation, of arbitration, of protocol violations - the language of courtrooms substituting for the language of care. Meanwhile, no durable payment architecture has ever been built, either to fix the past or to prevent its repetition.

The human cost is where the drama turns tragic. Pacemakers, stents, and cath lab consumables - the very implants that keep hearts beating - were withheld by suppliers who have simply run out of patience and credit. Government hospitals, once the last resort for the poor, now stand as empty as the private wards that have quietly withdrawn from the scheme. Patients requiring dialysis or emergency cardiac intervention are left with an impossible choice: pay over a lakh out of pocket or wait indefinitely for a system that has stopped moving. This is not an inconvenience. This is abandonment.

What is most damning is the casualness with which this recurring emergency is handled. Each time hospitals threaten to walk away, some face-saving formula is floated - recalled SEHAT funds, promised fast-tracking, and assurances of "clearing dues daily". Yet nothing changes structurally. Private providers, now escalating directly to the National Health Authority, are signalling that patience has run out entirely. The Government can no longer be a spectator. It built this ecosystem, invited hospitals into it, and encouraged citizens to depend on it. A scheme cannot be flagship in name and skeletal in funding. The curtain must fall on this cycle of neglect before it falls on the scheme itself.