Victims didn’t get insurance benefit due to ventilator norm

NAGPUR: Despite covered under the state government's Mahatma Fule Jeevan Dayi Yojana, a cashless treatment scheme for the poor, a number of patients reaching private hospitals after pesticide poisoning had to go back.

Till over a week ago, the scheme covered treatment on account of organo phosphate poisoning, requiring ventilator assistance during treatment. This means it did not apply if a ventilator was not needed. Patients who reached private hospitals before the stage when they had to be put on a ventilator could not undergo treatment in the clinics.

The crisis has finally led to an amendment in the scheme, doing away with the ventilator norm, said Kishore Tiwari, chairman of Vasantrao Naik Shetkari Swavalamban Mission (VNSSM).

There were many cases which needed immediate treatment but without a ventilator. According to the insurance package given to private hospitals, the non-ventilator cases could not be covered. Unable to afford private treatment, a number of patients went away from such hospitals, said a doctor in the district on the condition of anonymity.

There may be as much as 40 such patients who went back. As there was a rush, private hospitals could not afford cutting the cost. Such patients who could not afford to pay were referred to the government medical college (GMC) or any other public hospital, by the private hospitals, said a source. There are doubts on how many promptly reached a government hospital after that, the source added.

Under Mahatma Fule scheme, earlier named after late prime minster Rajiv Gandhi, hospitals are directly reimbursed for the treatment cost.

However, in poisoning cases, a rider on ventilator treatment has been put, which proved to be a major constraint during the crisis. Even as the condition has eased now, the decision has come only after a large number patients could get immediate medical care in a private hospital, said the source.

Tiwari said, "The matter was taken up by local doctors. Thereafter, I raised the issue with the state health department. Now, even non-ventilator cases are covered under the scheme. It was impractical to have such a condition," he said.

"It's not that patients who don't need a ventilator are not serious. It is needed only when the case worsens, which can be prevented by prompt treatment," said a source in the medical field.

Till now, even suicide cases due to poisoning were not covered under the cashless scheme on account of the condition on ventilator assistance. Pesticide consumption is also one of common modes of ending lives in Yavatmal, which is infamous for farmer suicides.

"The scheme should be framed considering typical conditions of a given area. In Yavatmal where suicides through poisoning are coming, the norms should be eased for availing cashless treatment," said a medical practitioner.

The source said cases of pesticides inhalation were far more complicated as compared to consumption which happens in suicides. The chemicals first hamper the central nervous system, soon leading to multiple organ failure. As the respiratory system is next to be affected, the patients need to be put on ventilators.

Though the cashless scheme could not be availed without a ventilator in government hospitals too, the rural folk could still afford it due to the low cost of treatment in general there, a source said.