MADURAI: Out of the 14 hospitals in Madurai empanelled in the ‘Innuyir Kappom-Nammai Kakkum 48’ scheme, a whopping 8,127 patients received treatment in five government hospitals in the past two years. The data provided by the Joint Director of Health Services, Madurai, also stated that the nine private hospitals empanelled in the scheme treated only around 200 patients during the period.
Under this emergency care scheme launched by Chief Minister MK Stalin on December 18, 2021, all victims, irrespective of whichever state or country they hail from, of road accidents within Tamil Nadu limits will be eligible for hospital treatment free of cost for 48 hours. Even those who are not registered under the Chief Minister’s Health Insurance Scheme (CMCHIS) can benefit from the scheme. As many as 692 hospitals in the state are empanelled under the scheme, including around 200 government hospitals.
Explaining procedures for admitting patients under the Innuyir Kappom scheme, the Chief Medical Officer of Virudhachalam Government Taluk Hospital Dr P Saminathan said, “After examination, the patients will be categorised into various colour zones -- red for emergency cases, yellow for urgent, and green for less urgent cases. Subsequently, the personal details from the Aadhaar card will be uploaded to the CM Insurance Scheme website. Now, the patient can obtain free treatment in any private or government hospital empanelled in the scheme for the next 48 hours. If they have the CM insurance card, they can avail free treatment even after the 48-hour period.”
Dr Saminathan attributed the low number of patients treated in private hospitals under the scheme to ambulance drivers always taking patients to government hospitals and ‘green zone’ applications often getting rejected by the portal in the past few months. “Instead of pumping all the funds into the insurance scheme, the state government could invest money directly to enhance the infrastructure of hospitals and purchase medical consumables,” he said.
“Under the CMCHIS, the government issues around 30% of the refund to the respective hospital and 40% refund to the insurance company. Doctors and paramedics who attend to patients through the insurance scheme will get an additional 15% as an incentive to be divided amongst themselves. However, the district administration asked us to pay the salaries of contract employees at the hospital with the CMCHIS refund money.
Lack of awareness among victims may be the reason for fewer persons approaching private hospitals under the Nammai Kakkum scheme, said Joint Director of Health Services, Madurai Dr R Selvaraj. “Further, most private hospitals accept only patients in the red zone category, as they are facing trouble claiming reimbursement for the other category patients,” he added.
Sources from the Government Rajaji Hospital (GRH) in Madurai said they used to treat 40-60 people daily under the Nammai Kakkum scheme in the initial stage. However, now the hospital deals with only 4-7 patients daily as the green and yellow zone approvals were unofficially revoked last year, they further said.
Meanwhile, an ambulance driver told TNIE that they usually shift accident victims to the nearest hospital, whether it be government or private. “There may be some drivers who always opt for government hospitals. In the scheme's first year, private hospitals hesitated to accept patients as they feared improper reimbursement. Also, some private hospitals with an eye on profit, wait for the 48-hour period to expire before starting major treatment procedures,” he added.
The scheme has completely failed to address its intended purpose, opined Madurai-based health rights activist C Anand Raj. “Out of the 8,127 cases, the GRH alone handled 6,228 patients. Does this mean that most accidents occur near the GRH or is no other hospital equipped enough to handle such patients? The state government must audit the treatment of accident patients in all private hospitals to ascertain the real reason why almost all the patients are taken to government institutions,” Raj demanded.
Patients treated in 5 govt hosps in Madurai under the scheme
Male: 6,884
Female: 1,240
Transpersons: 3
Total patients: 8,127
Claims settled: 6,809
Patients treated in 9 pvt hosps in Madurai under the scheme
Male: 173
Female: 27
Total patients: 200
Claims settled: 141