Is the government paying a price for its procrastination in seeking the evaluation of the Arogyasri scheme and a cost-benefit analysis?

Even as the budget allocation for the popular Arogyasri health insurance scheme has been going up significantly over the last six years -- reaching an estimated Rs.2,000 crore this year- so were the reports of its misuse, both by ineligible patients and private hospitals.

A proposal mooted two years ago by the Health Department to get the scheme evaluated by an expert agency has not seen the light of the day. The idea behind such an assessment was that Arogyasri was not meant to be a money spinner for private hospitals but was meant to improve health care for the poor. With the AP Superspeciality Hospitals Association and AP Private Hospitals and Nursing Homes Association setting May 3 as the deadline to stop taking Arogyasri cases unless the rates for treatment packages were revised, Chief Minister N. Kiran Kumar Reddy reviewed the Arogyasri scheme with officials on Saturday. He referred the demand of the private hospitals to the expert committee. Officials said the government lacked the political will to restructure the scheme is it would become unpopular by easing private hospitals without an alternative in the public sector. Had sufficient funds been allocated for strengthening primary and secondary health centres, district level hospitals, the financial burden on the scheme would have decreased gradually, said a senior official.

Another lapse was the government’s failure to delink Arogyasri with white ration cards, numbering nearly 7.5 crore and introducing special Arogyasri card. Also, the tendency of some private hospitals to run a battery of tests for patients to inflate the bill had undermined the credibility of the scheme. “It came to our notice that about 60 per cent of Arogyasri patients came from two districts, Hyderabad and Krishna district, accounting for 20 per cent of the population in the State. The scheme extended disproportionate benefits- more in the districts with a good number of private hospitals rather than the genuine white cardholders in backward districts with neither corporate hospitals nor government hospitals,” another official said. A series of checks are being considered to streamline the scheme.