Arogyasri scheme: Where does the buck stop?
By Express News Service | Published: 05th April 2013 08:04 AM |
Treatment under the Rajiv Arogyasri Scheme (RAS) in private hospitals may no longer be possible. Citing escalating costs of maintenance and overhead charges, private hospitals and nursing homes under the banner of the Andhra Pradesh Private Hospitals & Nursing Homes’ Association (APNA) and Andhra Pradesh Speciality Hospitals’ Association (ASHA) have demanded a 30 percent hike in reimbursments.
APNA and ASHA have already served a notice on the State Government threatening to stop treating cases under Arogyasri from May 4, if it fails to accept their demands.
‘’The intake of patients under RAS would be slowed down and we are planning to clear all cases under the scheme by May 3. Only those cases, that could be treated before May 4 would be considered,’’ Dr RS Saluja, immediate past president of APNA, told Express.
Of the nearly 7,000 hospitals and nursing homes (members of APNA) in the State, 300 are offering treatment under Arogyasri. Almost 90 percent of them have decided to stop the same from May 4. And, 25 of the 30 members of ASHA have joined them.
Several thousands of people avail treatment for diseases, which require surgery, under Arogyasri, free of cost. Most of those cases as of now are being treated in private hospitals, nursing homes and corporate super speciality hospitals.
Rajiv Arogyasri Scheme
Rajiv Arogyasri Scheme, the flagship health initiative of the State Government to provide quality healthcare to the poor, was the brain child of former chief minister late YS Rajasekhara Reddy. It was introduced on April 1, 2007.
Under the scheme, various serious aliments, which often require surgery, are treated. However, there are certain exceptions and those are not covered under RAS. High-end treatments like hip and knee replacement, bone morrow, cardiac and liver transplantations, gamma-knife procedures in neuro surgery, assisted devices for cardiac failures etc; and diseases covered by national programmes viz., TB, HIV/AIDS, Leprosy, Infectious diseases, Malaria, Filaria, Gastroenteritis, Jaundice etc. do not fall under RAS. A patient availing RAS can get treatment costing up to Rs 1.5 lakh per annum and there will be a buffer of Rs 50,000, if the treatment costs exceed Rs 1.5 lakh.
Blame Inflation, Not Us: Hospitals
Nearly two years ago, escalating overhead costs forced private hospitals and nursing homes to take stock of the situation and request the government to increase the amount reimbursed to them for providing treatment under RAS.
‘’At the time of introducing the scheme, we were asked to discharge our social responsibility by providing treatment at an affordable cost to the poor, who make up to 28 percent of the society. The government had agreed to reimburse part of the expenditure. However, instead of patients from poor families, those from affluent families too have started using the scheme and we ended up treating more than we agreed to,” a senior doctor said. To its credit, the government had never failed in reimbursing costs. However, the amount paid was in accordance with overhead costs six years ago. “Given the fact that costs of maintenance, property tax, electricity charges and salaries have increased significantly today, it has become imperative for us to ask the government to hike the amount,’’ another senior doctor, running a private hospital, explained.
Asked why they had decided on a strike, an APNA member said that their request had been pending with the government for the past 16 months. ‘’It is high time the government concedes our demand,’’ he said.
Govt Divided as Ministers Differ
The move of the private hospitals has brought fissures within the government to the fore. While Minister for Health DL Ravindra Reddy felt their grievance was genuine and their demands should be considered, Minister for Arogyasri Kondru Murali Mohan took serious note of the protest. He observed that it was private hospitals, which were benefiting the most from RAS and threats from them will not sit well with the government.
“We are examining the demands of corporate hospitals. If they come for talks, well and good. But the government will not be cowed down by threats,” he asserted. There are 100 more corporate hospitals willing to conduct surgeries, if the empanneled hospitals stop, he said.
However, he added officials were in touch with hospital managements for talks. “They render good services, but some extended ‘unnecessary service,” he alleged, while pointing out that Rs 1,000 crore -1,200 crore is being reimbursed to them.
He also said health cards will be provided to all the State government employees from Ugadi. Some sections of the society like advocates and journalists, who were not so far covered under Arogyasri, would also be provided health insurance soon, he added.
Pressure Likely on Govt Hospitals
In case, the government does not accept the demand of private hospitals and they stop treating patients under RAS from May 4, the pressure would surely be on government hospitals to take in patients.
Given the staff shortage and poor infrastructure in government hospitals, increased inflow of pateints under RAS would stretch them to the limit and may harm the patients too.