Health insurance should be improved, ‘One Nation One Health Insurance Policy’ should be implemented
Dr Ajay Khemaria. The latest figures of the Ayushman Bharat scheme show that 16.20 crore Indian families have been issued Ayushman insurance cards and so far two crore people have been treated under this scheme.
The government has spent a huge amount of Rs 24,683 crore for the treatment of the poor.
About 60 crore citizens are insured through these insurance cards. Undoubtedly, Ayushman is a big policy step, but disasters like corona infection have highlighted all the discrepancies in the public health sector.
Health insurance should be improved, ‘One Nation One Health Insurance Policy’ should be implemented
Public health insurance is also one such issue, which even after a big scheme like Modicare (Ayushman) urges consultation with our policymakers.
Talking about Kovid, under the Ayushman scheme 20.32 lakh samples were tested and 7.08 lakh patients were hospitalized, while the total number of infected patients is around 3.5 crore and the number of deaths is 4.5 lakh.
That is, only two per cent of the corona victims got treatment under the Ayushman scheme.
The question is, why could Corona not be treated inadequate numbers under this scheme consisting of 23 thousand affiliated hospitals of the country?
The answers are not difficult. The fundamental problem is the lack of uniformity in the policies of the government.
Public health insurance in India is actually a matter full of glaring discrepancies. What is needed today as a lesson from Corona is ‘One Nation One Health Insurance Policy’.
The government will have to fulfil its responsibility to ensure every person.
The government taking a big step like Modicare can provide authentic health insurance to every Indian like England, America, Brazil and other developed countries with little effort. About 60 crore citizens have already been covered under Ayushman Yojana.
At the same time, 13 crore people are under the purview of ESI, which is being increased to 20 crores by the Labor Ministry. There is a provision of CGHS for Central Government employees.
State governments also make some provision of health insurance for their employees. Here there is a need to integrate all the schemes and implement them.
Health insurance should be improved, ‘One Nation One Health Insurance Policy’ should be implemented
Something should also be done for the remaining population which is outside the purview of these schemes. This includes the middle and lower middle-class sections of the country.
It would be better if the government brings a law on compulsory health insurance in the country and all citizens should be included in the same scheme.
There should be a provision of premium for those who are capable. The compulsory insurance can be made available to all Central and State Government employees like Ayushman, ESI.
The arrangement of premium from their salary is also easy. Similarly, all private employers may be mandated to comply with nationwide integrated insurance from their employees.
Despite being opened to the private sector 20 years ago, health insurance has not proved to be beneficial for the common man. At its core is the lack of uniformity.
For example, there is no uniformity of premium between private and public sector insurance companies.
Ayushman provides for 918 disease packages, but Ayushman does not make any arrangements for many diseases like dengue, chikungunya and Japanese fever. For diseases like cancer, people have to get cancer top-up in their health policy.
The Indian insurance sector starts the process of reimbursement only on the hospitalization of the patient i.e. his critical condition.
If an insured person goes to the OPD for examination or treatment, then there is no benefit of insurance for him. There are 572 medical colleges in India, but private colleges do not treat the insured of Ayushman, CGHS or ESI.
This is because of the lack of uniformity in the rates of diagnosis, treatment and surgery. For example, ESI arranges three thousand rupees in appendix operation, but in private hospitals, its cost is more than 10 thousand.
In fact, except for a few ESI hospitals with a coverage of 13 crore people, there are no facilities like MRI, dialysis and CT scan anywhere. It is clear that Indian Public Health Insurance is not inclusive nor is it working with integrity.
The government has spent a huge amount on Ayushman Bharat, but there are discrepancies in it. First of all, the provision of OPD and recruitment has to be abolished.
In line with the concept of universal insurance, the treatment of all diseases has to be made part of the insurance. This is the case with the British National Health Service.
This will eliminate the hassle of notifying diseases again and again. Also, every health institution in the country should be brought under its mandatory purview so that the insured does not have to go to the notified hospital for treatment in case of illness.
The rates of treatment under universal insurance coverage should be made practical and uniform, which may also be revised over a period of time.
To make insurance target-oriented, the government should also take steps that PG seats of all medical colleges should be attached to the PHC, CHC or wellness centre of that area instead of the college.
Their postgraduate students work at these centres and go to college only for theory. This will make professional doctors available in rural areas at all times, which will help in making initiatives like Modicare result oriented.
