But private hospitals cry hoarse as treatment costs not revised; Doctors say it is an election stunt

Mysore/Mysuru: With the State Government reintroducing the Yashaswini Health Insurance Scheme, the private sector will also be benefitted as the area of coverage has been expanded. The scheme was largely beneficial only for farmers earlier.

However, private hospitals across the State have taken severe exception to the scheme as the treatment and surgery rates have not been revised though the Government has relaunched the scheme. They have resolved to implement the scheme only if the Government gives a written assurance of fulfilling their demands as most of the private hospitals are under severe financial crisis.

The scheme which was discontinued in 2018 has been reimplemented and will be effective from Jan. 1, 2023 to Dec. 30, 2023. Beneficiary families will be eligible to avail health benefits up to Rs. 5 lakh per annum. A four-member family in urban areas must pay

Rs. 1,000 annual premium and a family from a rural area should pay Rs. 500. In the case of additional members they should pay 20% extra (Rs. 100 each).

Employees whose monthly pay is Rs. 30,000 or Rs. 3.6 lakh per annum are eligible. Though provisions have been made for even those who have Ayushman Bharat cards to enrol for Yashaswini, they can use the benefits of only  one scheme.

In all, 1,650 types of ailments will be treated and every member of the scheme will be issued a bar-coded card with an unique ID number. Besides, 823 surgeries are also covered.

“The scheme is being reimplemented but the cost of treatment has been slashed. How is it possible to do surgery for Rs. 8,000 to Rs. 10,000? The Government seems to have decided hastily with an eye on elections due next year, without discussing the matter with the private hospitals,” said a doctor.

‘No agreement unless our demands are met’

Speaking to Star of Mysore, Mysuru Association of Hospitals and Nursing Homes and Diagnostic Centres (MAHAAN) President Dr. K. Javeed Nayeem said, “MAHAAN has decided not to sign the agreement to implement the scheme.”

The agreement will be signed only if there is a written assurance over changes in guidelines, an increase in the tariff, clearance of arrears and swift reimbursement of the amount. In the existing scenario, there is a prolonged delay in reimbursement with arrears running up to several crores of rupees, he added.

“There has been a surge in the prices of medical equipment and also the cost of treatment. How can we provide treatment at the old tariff,” he questioned. “The Government has not discussed this with the heads of private hospitals and we do not have any information. If beneficiaries want special wards under the tariff fixed by the Government, it will be like treating them with our own money,” he said.

If the Government fixes Rs. 8,000 for any major surgery, how to distribute the same among the beneficiaries? In case of any emergency cases involving pregnant women at midnight hours, the doctors should be summoned from home. It requires at least two Paediatricians, a Gynaecologist, Nurses and an Anaesthetist, he noted and said Rs. 8,000 is way less. 

“The Government which has been showing interest in implementing the scheme ahead of elections will forget the same after the elections. They will even lose interest in either continuing or extending the scheme,”Dr. Javeed Nayeem said.