THIRUVANANTHAPURAM: The lack of preparatory work and poor implementation have marred the Karunya Arogya Suraksha Padhathi (KASP), the state government’s ambitious comprehensive health insurance programme. The KASP was formed by integrating different public healthcare and insurance programmes, including the popular Karunya Benevolent Fund (KBF) and the Centre’s Ayushman Bharat-Prime Minister’s Jan Arogya Yojana.
While the KASP offers a maximum health coverage of Rs 5 lakh to the members every year, the KBF’s maximum assistance to a family was Rs 2 lakh (except kidney patients, Rs 3 lakh and haemophilia patients, limitless). But the new insurance scheme does not offer certain benefits provided by the KBF inviting sharp criticism from the public. While the KBF provided assistance for selected outpatient treatments, the KASP provides assistance only for inpatient treatment.
Being a health assurance scheme, the KBF also provided assistance for post-transplantation treatment and haemophilia, a disease normally not covered by an insurance scheme. In KBF, the sanctioned money for a procedure can be used for related medical expenditure. For eg, if Rs 2 lakh was sanctioned for surgery and if only Rs 1.50 lakh was spent for the surgery, the rest of the amount can be used for buying post-surgery medicine.
Enrolment
At present, 42 lakh families in the state, beneficiaries of the erstwhile schemes - RSBY of the Centre and CHIS of the state government - are covered under the KASP. The government wants to expand its coverage by enrolling more people in a phased manner. So far, the government could not even replace at least a quarter of the erstwhile RSBY/CHIS cards with that of the KASP. New enrolments remain on paper after its launch on April 1.
health facts
It’s just what the doctor ordered as far as Keralites are concerned! The KASP will cover injuries during a suicide attempt and alcohol-induced diseases.
Kerala is said to be the first state in the country to introduce a public insurance scheme with these exemptions, normally not covered under health insurance programmes.
Insurance provider
Reliance General Insurance which quoted an annual premium amount of F1,671 per person was chosen as the insurance provider. A total of 1,824 health packages are offered under the KASP when compared to the 1,354 in the AB-PMJAY.
HaemophiliaThe future is uncertain for over 1,500 haemophilia patients who were beneficiaries of the KBF. The KASP does not have a provision for assisting haemophilia patients.
Though “caring of haemophilia patient (injection of haemophilia factor)” and “post kidney transplantation - immunosuppressant” were among the list of procedures approved for the KASP, both items were excluded through a government order issued on February 4.
The KBF was the finest state-run scheme in the country for haemophilia patients, according to the Haemophilia Society of Kerala. In other states, a haemophilia patient in a critical condition needs approval at different levels to get free injections of clotting factor. The KBF had given identity cards for over 1,500 haemophilia patients in the state.
Thomas Isaac, Finance Minister
No KBF beneficiary will be denied treatment under the new system. At present, a temporary arrangement will be in place to provide treatment to KBF beneficiaries who are not included in KASP. The state is planning a permanent system covering all from April 2020.