As India debates universal health coverage, one of the first schemes of this nature that attempted to provide a semblance of state-guaranteed healthcare to the needy — Andhra Pradesh’s Arogyashri — is proving a heavy burden on the exchequer. Not only does the scheme take away about 50 per cent of the total Plan money on health in the state, it has also garnered criticism for promoting costly surgical interventions, many of them in the private sector, over primary and preventive healthcare.