Madurai: While many populist schemes like the distribution of fans, grinders and gold for thali of late Chief Minister Jayalalithaa’s regime have often been criticised for being just freebies and not welfare policies, medical fraternity and health rights activists opine that the expansion of health insurance scheme can be termed a real success since it not only helped in more people getting quality healthcare but also in improving government hospitals.
Though the scheme was introduced by DMK government in 2009 as ‘Kalaignar Insurance Scheme,’ the usage remained predominantly with private hospitals. “There were many private hospitals that benefitted through the scheme by performing large number of surgeries,” said a senior doctor from Government Rajaji Hospital, speaking on anonymity.
It was in 2012, after the AIADMK came to power, that the scheme was repackaged as ‘Chief Minister’s Comprehensive Health Insurance Scheme’ by bringing more medical procedures under coverage.
“Importantly, certain medical procedures were reserved only for government hospitals. Also, 60:25:15 ratio in utilisation of insurance money was introduced, by which 25 per cent money claimed for a procedure was made available for improving hospital infrastructure and 15 per cent as incentive for the medical team that did the procedure,” said K. Senthil, State president of Tamil Nadu Government Doctors’ Association.
C. Anandaraj, a health rights activist from Madurai, who has tracked the usage of the scheme over the years by information obtained through Right to Information Act, said that the changes in 2012 resulted in sharp increase in the usage by government hospitals.
“The increase was manifold, particularly in critical areas like heart and kidney related ailments,” he said. He added that even the taluk-level hospitals that rarely performed any surgeries until then started performing more surgeries .
A former Dean of GRH, on anonymity, said that the revised scheme also gave a lot of autonomy for respective heads of departments in purchasing high-end medical equipment with the 25 per cent of the claimed insurance money. “Earlier, we had to plead for money from the government and go through a lot of approvals. That situation completely changed,” the official said.
While acknowledging that the scheme had helped people from economically-backward background in getting quality healthcare, N. Lakshmi Narasimhan, State president of Service Doctors and Post Graduates Association, however, struck a slightly different note.
“Though usage by government hospitals has increased, private hospitals still dominate the scene. Even in government hospitals, if a person whose income is not as low to come under CMCHIS goes for a surgery, treatment is either delayed or denied since there is no incentive in operating the person,” he said.
“Instead of spending thousands of crore for the insurance scheme, the money should have been spent in improving public health systems, which will have a lasting impact,” he said.
