By Dr. K. Javeed Nayeem, MD

I’ll start my article today with a parable that is very relevant to the present times. It appears, there were a cow and her calf, reared by a farmer, dwelling in his farm, that stood next to a dense forest. The mother and calf duo would graze every day, on the lush green grass that grew abundantly in the meadows on the fringe of the forest. But because a fierce tiger was known to be dwelling in the depths of the forest, the cow had warned its calf that tigers can be very dangerous and had naturally told it to be always wary of the presence of the tiger.

The very obedient calf, always keeping these words of caution in its mind, would always maintain a safe distance from the forest while grazing.

But one day it found the tiger standing with a broad smile at the edge of the forest and beckoning to it to come close. Reassured by the smile, the calf overcame its fear and ventured close to the tiger which said that it just wanted to be friends with it and all other animals in and around the forest.

Quite surprised by this change, the elated calf rushed to its mother and told her about this new development, when the cow smiled in turn and calmly told its calf that such things only indicated that elections were around the corner!

That is exactly what seems to be happening in our State too. Elections are around the corner and tigers are trying to befriend cows. If we look around closely, we are bound to discover that the Government is trying very hard to please the voters with a plethora of welfare measures, supposedly aimed at improving the lot of the impoverished in the State.

I need not elaborate on what these measures are but I would certainly like to include under them the terrible hurry with which the State Government is trying to resuscitate the Yeshasvini Scheme that has been lying completely dead for some time and which for a short while, provided almost free medical insurance to our masses, so that even almost penniless people could seek medical care, not just in Government but also in the best Private Hospitals.

Very notably, this was a very short-lived scheme and I’m not surprised that it was so, because such schemes do not last long for two very important reasons.

Firstly, any Scheme that does not make sound financial sense to sustain itself perpetually, falls flat on its face miserably and there is nothing surprising in this. Secondly and more importantly, for it to remain alive, the Government that launches it should continue to promote and sustain it beyond its vote gathering utility period.

This is abundantly visible in the present fate of the hundreds of Indira Canteens across the State that were started with much fanfare, not very long ago, by one Government, only to become defunct and transform themselves into haunts of vagrants and anti-social elements, the moment power changed hands and went to another Government.

The original version of the much-hyped Yeshasvini Scheme met a similar end and its newer avatar, that now comes at a much lesser and therefore more attractive cost to the beneficiaries, is bound to meet the same fate. That is, if it does take off, which to me, does not seem very likely, although it is designed to take effect from today. The reason for this is that, although the date is set, its fate is not yet certain, with almost all the Private Hospitals across the State, that are supposed to keep it going, refusing in unison to accept it under its existing terms and conditions.

But just to win the support of the public, for electoral gains, the Government is right now making very tall claims about the number of hospitals that have already joined this scheme and how wonderfully it is going to transform the lives of the poor. Nothing could be farther from the truth. This kind of propaganda is also meant to coerce reluctant hospitals to join the scheme out of the fear of being left out of the race that although profit-less by itself, might get more footfalls to their doors, familiarising the public with the services available there.

While talking of the terms and conditions, I would like to give you just one example of how absurd and comic they are. Yes, these are the two most apt and appropriate words to describe them. Talking of just one procedure to illustrate my point, under this scheme, empanelled Private Hospitals are supposed to do a Caesarean Section, a procedure to deliver a baby surgically, for a princely sum of rupees nine thousand. Now, this procedure requires a fully equipped operation theatre, lifesaving and sustaining equipment, the services of a Gynaecologist, at least one medically qualified doctor to assist in the procedure, an Anaesthesiologist, a Paediatrician to manage the baby immediately upon delivery, assisting OT technicians, nursing and housekeeping staff.

Now can someone in the Government tell me how much of this amount the hospital is going to keep aside as expenses and distribute it in proportion to the nature of service rendered by each one of the team members and how much the hospital itself will be able to take as its share, by way of profit? This is after paying its taxes, water, electricity and waste disposal bills and  the interest on its bank loans, all of which are charged at commercial rates without any rebates.

Because brevity is what keeps things clear when we talk of highly technical matters, I’ll not go into the details of any other surgical procedures but only give you the rates of just two other commonly done procedures. An appendectomy is supposed to be done at rupees ten thousand and for a cholecystectomy, that is the removal of the gall bladder, the hospital is supposed to get rupees twelve thousand. And, that’s not all. Very often, as is the norm in all transactions with the Government, the bills due to the participating hospitals, which often run into lakhs and sometimes crores of rupees, are not paid for long periods of time. Most hospitals in the State are yet to receive their payments due from the last and now defunct Yeshasvini Scheme, even to this day. This very distressing situation makes it a mockery of the whole arrangement because, very often, the interest the hospitals would have paid to their lending banks to survive through these delayed payments would have crossed the bill amounts themselves!

Added to this, if you take into account the ever-present but most often unmentionable need to grease greedy palms to get payments released, it is a crime which hospitals are forced to abet, just out of sheer helplessness, making the whole experience very disgusting.

The question that comes to mind here is why should private health care providers suffer at the hands of a system that is simply unable to do any good to the public by itself, and yet has to win elections, which as we all know, will eventually do good only to self-serving politicians?

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