Universal Healthcare: APL families to shell out 70 per cent.

Move comes as a surprise as earlier, under Rajiv Arogya Bhagya, people of same category had to pay only 30 per cent of the cost.

Published: 05th September 2017 07:32 AM  |   Last Updated: 05th September 2017 07:32 AM   |  A+A-

Image used for representational purpose

Express News Service

BENGALURU: The state government has assured Universal Healthcare for all its citizens from November 1, but it has now come at a cost for above poverty line (APL) families. Patients under category-B (which includes APL families) will have to foot 70 per cent of their medical expenses.

This is in contradiction to what the state announced in 2015. It had promised to give a subsidy to APL (above poverty line) families under a new scheme – Rajiv Arogya Bhagya (RAB), under which, it was said that APL patients will have to shell out only 30 per cent of the total expenses and the state would bear the rest. However, through the cabinet clearance on Monday, it has been announced that the state would now foot only 30 per cent of the cost. Now, under the Universal Health Coverage, all those who come under category-B will have to bear 70 per cent of the expenses.

When Express contacted the Suvarna Arogya Suraksha Trust (SAST), a senior official, who spoke on condition of anonymity, said that through a series of discussions, they arrived at this conclusion as the state would not be able to pay all expenses. “With enrolment through cards, the number of beneficiaries will increase. The government will not be able to bear 70 per cent of the treatment cost as decided during the launch of Rajiv Arogya Bhagya,” the source said.Dr Sudha Chandrashekar, director, Suvarna Arogya Suraksha Trust, defended the state government citing that previously, it was only tertiary care that was provided under RAB. “But now, the state will also subsidise primary and secondary care. We have to look at it from a larger perspective,” she added.

‘Not all diseases covered’

The state government’s decision has drawn flak from activists. Dr Akhila Vasan, member of Karnataka Janarogya Chaluvali, claimed that the state was doing little strengthen the public health sector. “All the money is channelised to private hospitals. Besides, these schemes cover a narrow range of services. It is not universal in the true sense as not all diseases are covered,” he said.

“The very point about this ratio reversal shows that the state’s plan to provide Universal Healthcare by empanelling private hospitals is incorrect,” activist Vinay Srinivasa said. He also asked why government wasn’t footing bills for non-procedural treatments. “What happens to those who are on life-time dialysis? This will only benefit private hospitals,” he added.

Poor response the reason?

Sources in the Suvarna Arogya Suraksha Trust (SAST) said this move could be a result of poor response to Rajiv Arogya Bhagya (RAB). The scheme that was launched in 2015 has only seen 5,306 beneficiaries till date. Whereas Vajpayee Arogyashree, a scheme for BPL families, has over 2 lakh beneficiaries so far
Most beneficiaries under Rajiv Arogya Bhagya seek cardiac or oncology treatment
Mysuru region: Mandya, Kodagu, Udupi among others had seen best response


What Rajiv Arogya Bhagya offered(Source: SAST website)

Co Payment Mechanism
For General Ward:
The basic package rate alone is admissible and it is shared between the Suvarna Arogya Suraksha Trust and the beneficiary in the 70:30 ratio and they are not entitled for any upgraded services.
For semi-private and private wards:
The Suvarna Arogya Suraksha Trust shall be liable to pay 50 per cent of the basic package rate and the other 50 per cent of it, along with the remaining balance portion of the total package rate, is liable to be co-paid by the beneficiary.

Universal Healthcare (Source: Department of health and family welfare IEC material )

Secondary Care:
About 1,000 procedures can be done in government facilities, which will be provided free of cost to the entire population of Karnataka, including A and B categories
For complicated secondary procedures:
Category A beneficiaries can avail facilities free of cost. For category B, state government will reimburse 30 per cent of the medical expenses


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