The erstwhile Karunya Benevolent Fund (KBF), a one-time medical assistance fund (up to ₹3 lakh) for catastrophic illnesses which has been merged into the new integrated health insurance scheme Karunya Arogya Suraksha Paddhati (KASP), is turning out to be a perpetual noose for the government.
Even though the KBF has been stopped since June 30, popular pressure has now forced the Health Department to issue a new order, which says that all those people who were eligible for the KBF but are not RSBY or KASP card holders will “continue to get treatment benefits in all empanelled hospitals for catastrophic illnesses as per the KASP packages at KASP rates”. This will be operational for the current financial year 2019-20 only.
The order further says the government will provide payment through the State health agency to these empanelled hospitals at KASP package rates for patients who were eligible for KBF benefits.
Self declaration
The patient will give a self-declaration to the effect that he/she has not earlier availed himself of KBF benefits. KASP beneficiaries are those who belong to the BPL category. But KBF benefits could be availed of by those in the BPL category as well as those in the APL category whose annual income did not exceed ₹3 lakh. After the merger, when the Finance Department stopped receiving applications for the KBF, the “in-between” category of people who are not RSBY/KASP card holders found themselves in a spot. This is an issue that was anticipated in the transition phase, but there seems to have been no planning on how these issues would be handled.
Complication
“The new order has only complicated things. It is quite evident that the KBF and its legacy issues are going to be a perpetual headache for the government because the very same issues will crop up next March also. Besides, this is going to have serious financial implications for the government, which will have to pay the insurance company (Reliance) premium for KASP holders for the entire year and and at the same time find additional money to finance the treatment of the KBF beneficiaries,” a senior health finance professional told The Hindu .
An estimated 40,000 persons avail themselves of KBF benefits annually, and hence the government will have to cough up crores to finance the treatment of these persons under the KASP. “Next year, we will have to study and redraw the entire health insurance scheme and do a package rates rationalisation,” Principal Secretary (Health) Rajan N. Khobragade says.
