Universal Health Scheme hinges on referral system

This health model, with all schemes under one umbrella, will be launched on Friday

February 28, 2018 11:57 pm | Updated March 01, 2018 07:59 am IST - Bengaluru

 Under the scheme, all the 1.4 crore households in the State will be eligible for cashless treatment for up to ₹1.5 lakh in govt. and private hospitals. File

Under the scheme, all the 1.4 crore households in the State will be eligible for cashless treatment for up to ₹1.5 lakh in govt. and private hospitals. File

Creating a sustainable model of healthcare for all, Karnataka will roll out the Universal Health Coverage (UHC) from March 2, bringing all government health schemes under one umbrella.

Under UHC, all the 1.4 crore households in the State will be eligible for cashless treatment for up to ₹1.5 lakh in government and private hospitals. However, patients must first visit a government hospital and if referred, can go to a private hospital.

The Health and Family Welfare Department has identified 10 government hospitals that one can approach for getting enrolled under the UHC. The hospitals are: Bangalore Medical College and Research Institute (BMCRI); K.C. General Hospital; Sri Jayadeva Institute of Cardiovascular Sciences; Karnataka Institute of Medical Sciences, Hubballi; Vijaynagar Institute of Medical Sciences, Ballari; McGann Teaching District Hospital, Shivamogga; Mandya Institute of Medical Sciences; Gulbarga Institute of Medical Sciences, Kalaburagi; Sri Narasimha Raja (SNR) District Hospital, Kolar; and Wenlock, Mangaluru. The services of the existing empanelled private hospitals under the various schemes will be continued, unless the hospitals do not want it.

However, an expert committee to fix prices of various procedures for scheme patients, under the Karnataka Private Medical Establishments (KPME) Act, is yet to be set up. This has made private doctors sceptical about the new scheme. “Although we support the scheme, we are still not sure what would be the rates of various procedures. We will wait and watch till the expert committee to fix the prices is set up,” said C. Jayanna, president (Elect) of Private Hospitals and Nursing Homes’ Association (PHANA).

All citizens can use the benefits of the new scheme, regardless of income.

A top official explained that under the new scheme, a patient will first have to visit a government hospital, where he or she will receive treatment, free of cost. The patient can visit a private hospital only if the government hospital is not equipped to provide the required treatment, and has referred the case to a private hospital.

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