The Karnataka government’s proposal to insist on patients availing various government-sponsored health insurance schemes to first approach public hospitals for treatment, and if the facility for a specific treatment does not exist there, then get a referral letter to seek treatment at a private hospital, is illogical and against public interest. It will only lead to corruption, become more bureaucratic and cause harassment to patients. There will be long queues in front of ill-equipped government hospitals and it will be a needless hassle. Doctors or whoever has the authority to issue certificates may cause unnecessary delays and crucial time may be lost for the patients. Health Minister Ramesh Kumar, who has taken some bizarre decisions, should forthwith drop this ill-considered, anti-people plan.
Karnataka has been a pioneer in the field of state-sponsored health schemes in the country. The Yeshasvini Cooperative Farmers Health Care Scheme, introduced in 2003, which helped the poor get their surgeries done at state-of-the-art hospitals at minimal costs, was a trendsetter. But, over a period of time, a plethora of government-backed insurance schemes introduced for different sections of people, has deteriorated in quality, mainly benefiting private hospitals. Despite having some of the best hospitals in the country and some unique schemes such as Yeshasvini, Rashtriya Swasthya Bima Yojana and Vajpayee Arogyashree Scheme, Karnataka fares poorly in health indicators when compared with the other southern states. The rationale for engaging the private sector in providing care under insurance schemes was the lack of capacity and specialised equipment in the government sector. But, in many instances, government doctors are allegedly bribed to refer cases to empanelled private hospitals for unwanted “procedures” or surgeries, and the hospitals in turn apply the most expensive “packages” to extract the maximum amount from insurance companies.
The state government not only needs to allocate more funds to the health sector which is an abysmal 2% of the State Gross Domestic Product, but re-orient the health insurance schemes keeping the patients’ interests in mind. There should be easy accessibility for patients to get treatment. If they are eligible, the facility must be available, else people will stop using it altogether. If the government finds some of the schemes burdensome, it should scale them down and ensure that people get treatment for more complicated surgeries at private hospitals. Besides, it has been noticed that out-of-pocket expenses for patients are continuously on the rise. Time has come for the government to set up an independent authority of experts to monitor the expenses and clear the payments under various schemes so that people derive the maximum benefits.
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