Many patients who have undergone psychiatric treatment are losing out on the benefits provided by the Rashtriya Swasthya Bima Yojana (RSBY), on the pretext that ‘psychiatric and psychosomatic illnesses’ are not included in the scheme.
This is happening at a time when the High Court has directed the removal of psychiatric and psychosomatic illnesses from the lists of ‘exclusions’ under the RSBY. The scheme was implemented in 2008 by the Centre to aid patients in the BPL category.
Dr Anoop Vincent, secretary, the Ernakulam Psychiatric Society, said that even patients with acute illnesses could not avail of the claims, as the insurance authorities reject their claims by pointing out that the medications are taken for minor psychiatric problems.
“The claims of one of my patients who suffered from cardiac arrest were rejected just because he had taken medicines in the past for a minor psychiatric illness,” he added. Dr Anoop said that mental-health problems are showing a steady rise, especially among the underprivileged population, along with a rise in alcoholism and suicide tendencies.
“Unfortunately, like psychiatric illnesses, suicide tendencies and alcoholism are included in the list of ‘exclusions’. In short, a patient under the BPL category does not get any benefits, irrespective of the severity of his/her illness,” he added.
The Kerala HC, on January 2013, had ordered the removal of psychiatric and psychosomatic illnesses from the list of ‘exclusions’ under Rashtriya Swasthya Bima Yojana. Even the Ministry of Labour and Employment has agreed to modify the list of ‘exclusions’. But the state government is yet to act on this, said Dr Jayasurya, Associate Professor, Cochin Cooperative Medical College, Kalamassery, who moved a submission in this regard through an amicus curiae in the HC. “Psychiatry should not be excluded from the scheme, as India has ratified the international conventions on the rights of people with disability,” he said.
Sukumar, executive director, the Comprehensive Health Insurance Agency of Kerala (CHIAK), which is the implementing agency of the scheme, said that some issues have been raised by the Reliance insurance company. “We had signed the tender with them before the court order. Hence, we will have to wait until the tender period is over”, he said.
Nivedita P Haran, additional chief secretary and director, Labour and Rehabilitation Department, said that she will look into the matter.