Streamline medical benefit schemes, private hospitals forum tells govt

Karnataka Private Hospitals Forum (KPHF) has threatened not to implement Rajiv Arogya Scheme if the State government did not recitfy the flaws in the existing schemes. 

Briefing reporters, forum members claimed that “frauds” in Yeshasvini Scheme, Vajpayee Arogya Shree Scheme, Thayi Bhagya Scheme and Baala Sanjeevini be immediately addressed. 

On Saturday, private hospitals refused to treat patients covered under various State government schemes, demanding the same. KPHF President Dr Ramdev said: “Due to loopholes in the system, facilities offered by the State to Below Poverty Line (BPL) cardholders do not reach the actual target and there were irregularities in issuance of BPL cards. “The Lokayukta reports indicate there are 38 per cent fake BPL card holders. As a result, we see more beneficiaries.” 

The forum members said considering Lokayukta reports, out of six crore population , over four crore have BPL cards. However, HCG Hospital chairman Dr Ajay Kumar said private sector was willing to extend full support if there are no loopholes in the system.
 According to KPHF Coordinator  Dr Prashant B Katakol, a revision of prices was also essential, besides bringing all schemes under IRDI, the authority that regulates all schemes. 

“People come in cars to claim BPL benefit. There are cases where one person gets covered under various schemes,” he added, demanding the existent gross overlap of population covered for same illness under various schemes be sorted. 

He said only three to five per cent of all medical treatment involved surgical procedures while the rest were admissions due to non-surgical ones like typhoid, hypertension, diabetes and others. 

“Through the scheme, only 3 to 5 per cent of treatment requirements are being covered. What about the rest for which people incur out-of-pocket expenses? The schemes are not comprehensive and holistic,” he opined. The forum said there was an urgent need for revision of procedural charges and services under the existing health schemes scientifically and reviewing the same annually.