Central Health Insurance Scheme misses goal

Published: 18th March 2013 12:40 PM  |   Last Updated: 18th March 2013 12:40 PM   |  A+A-

 Rashtriya Swasthya Bima Yojana (RGBY) is an attempt by the Central Government to provide health insurance to low income workers. But at the grassroots, the scheme remains meaningless for many poor villagers. One such villager is Tapan Kumar Parida of Majhikora village under Balikuda police limits in Jagatsingpur.

A farmer by profession, though he is enrolled as a beneficiary of the RBGY scheme and even has a RBGY health card, Tapan did not receive a penny when he was admitted to a private hospital in Cuttack for treatment. Instead, he was harassed by the hospital authorities when he claimed for financial assistance under the scheme.

On January 16, Tapan was critically injured in a road accident and admitted to Balikuda Upgraded Primary Health Centre and then taken to Jagatsinghpur Hospital. Doctors there referred him to a surgery specialist for operation of his leg.

Later, Tapan was admitted to a private ADD Hospital at College Square in Cuttack as it is a Government empanelled hospital for the scheme. He was operated upon, underwent grafting and treatment continued till February 26. However, after treatment, the doctors demanded Rs 25,000 as medical expenses. Though Tapan and his family members produced the official papers and health card of the RGBY scheme, they allegedly paid no heed.

“I had to mortgage my one acre agricultural land for Rs 20,000 and some gold ornaments for Rs 5,000 to bear the medical expense. My son was discharged recently after I cleared the dues, but they did not give us any insurance benefits for reasons best known to them,” said Tapan’s father Shyamsundar Parida.

Though officials of ADD Hospital refused to comment on Tapan’s case, they said an amount of Rs 20 lakh is already pending with the State Government towards the previous insurance claims that were made in the hospital under RGBY.

Meanwhile, Tapan has written letters to the Secretary of Union Ministry of Labour and Employment, Secretary of Labour Department, Government of Odisha, Jagatsinghpur Collector and Assistant Labour Commissioner (ALC), to conduct an inquiry into the case and initiate action against the authorities of the private hospital.

ALC, Jagatsinghpur, Ajaya Kumar Pattnaik said the Labour Department has asked an Assistant Labour Commissioner to conduct an inquiry into the issue and steps will be taken on the basis of enquiry report.

The scheme was launched by the Ministry of Labour and Employment to provide health insurance coverage to people living below the poverty line in 2008.

The main objective is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalisation.

Beneficiaries under RSBY are entitled to hospitalisation cover upto Rs 30,000 and they need to pay only Rs 30 as registration fee while Central and State Governments pay the premium to the insurer selected by the State Government on the basis of a competitive bidding.

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