The Vasundhara Raje government has decided to downsize the two main social sector schemes — Chief Minister's Free Medicine and Diagnostics and the Food Security Schemes — in the State by re-visiting the eligibility criteria. While the free medicine and diagnostics scheme will be made targeted from the existing universal, by reviewing the food security scheme, the government aims to remove 85 lakh people from the list of beneficiaries.
The free medicine and diagnostic scheme will be available only for the Out Patient Department visitors in public health facilities, if they are beneficiaries of the Food Security Scheme. For the In Patient Department visitors, the government plans to launch an insurance scheme covering treatment cost ranging between Rs. 30,000 to Rs. 3 lakh.
Experts and activists believe that if this happens, nearly half of the State's population will eventually be excluded from these schemes. “We strongly denounce the government's decision of downsizing the two schemes through ‘targeted intervention’, instead these should be strengthened and made more comprehensive rather than curbing them down,” says Narendra Gupta, convenor of Jan Swasthya Abhiyan.
According to him, after the introduction of the free medicines and diagnostics scheme in Rajasthan, the number of patients who required hospitalisation has doubled and those who do not require admission have tripled. This could only happen because of the universal nature of the scheme and no patient was required to establish eligibility of any kind. However, even after this huge increase in the number of people seeking medical care, the percentage of patients seeking assistance from public health facilities is still 30 per cent in the OPD and 60 per cent for IPD, Dr. Gupta explained.
On the introduction of insurance scheme for hospitalisation, Dr Gupta said there was enough evidence to show that health insurance have been widely misused by the hospitals and led to unnecessary hospitalisation, inflated medical bills and administration of irrational medicine. “A scheme like this had been introduced by Vasundhara Raje in her previous regime but had to be withdrawn,” he said adding that it had a “hidden agenda” of privatising and commercialising healthcare.
Chief Minister Vasundhara Raje had, in her Budget speech, said the eligibility criteria of the free medicine and diagnostics scheme would be re-worked and an insurance scheme introduced. The government has pointed out, on many occasions, that the scheme was putting a huge burden on the State resources as a large number of people from the neighbouring states were benefitting from the scheme and there was not enough infrastructure and human resource to deal with such a rush, and hence the scheme needed to be rationalised. While the budgetary allocation for the scheme will continue to be Rs. 300 crore — as last year — the number of beneficiaries will be reduced.
On Wednesday, the government announced in the Assembly that it had set up a committee under the Additional Chief Secretary S.C. Rajan to rework the list of beneficiaries of the Food Security Scheme and expects to reduce the number by 85 lakh. Food and Civil Supplies Minister, Hem Singh Bhadan told the House that the previous government had included ineligible families in the list of beneficiaries with an eye on elections. According to him, 5.31 people were made beneficiaries instead of the targeted 4.46 crore
Unimpressed by the argument, Kavita Srivastava of PUCL said there is evidence to show that the universal free medicine scheme had lead to increased access to health services by women and girls who were earlier denied due to costs. The schemes, thus, turned out to be crucial towards health and women empowerment. On the one had, the Union Government announced free universal health care in the Budget, on the other hand Rajasthan — which pioneered the scheme and received accolades from the World Health Organisation — is trimming it, she pointed out.
