Kerala has moved a step closer to achieving the universal health coverage by integrating the numerous healthcare protection schemes in the State, including Karunya Benevolent Fund (KBF), into a new comprehensive health insurance scheme.
The new scheme titled “Karunya Suraksha Padhati” will now replace the State’s current comprehensive health insurance scheme (RSBY-CHIS/CHIS Plus) and KBF.
Aligning with the Centre’s newly announced National Health Protection Scheme (NHPS), which offers a health protection coverage of ₹5 lakh for a BPL family, the new scheme will cover all major secondary and tertiary medical care services, including the treatment of cancer or cardiac diseases, in all empanelled public or private hospitals.
Integration of the various health beneficiary schemes had been a promise made in the 2016 revised State Budget presented by Finance Minister Thomas Isaac. At present, Kerala has at least nine beneficiary schemes.
These schemes are run by different departments, with separate guidelines and there is considerable overlap between these schemes in terms of coverage, benefit package and delivery of services. This overlap has resulted in duplication of resources for the same schemes.
“Integration of these schemes means that the State can utilise the same budgetary allocation to give better health protection for the people. All States have been given flexibility in implementing the NHPS. We are thus using the NHPS framework and its robust IT platform to integrate and monitor all existing schemes,” a senior health official said.
From a patient’s perspective, he no longer need worry about which scheme or the extent of coverage he is eligible to claim. Neither does he have to run from one department to another to get his application processed.
The new scheme ensures cashless hospital services at a single point delivery.
The Centre will provide the Pradhan Mantri Rashtriya Swasthya Suraksha Mission (PMRSSM) software.
Six-member panel
The government has appointed a six-member committee with D. Narayana, the Director of Gulati Institute of Finance and Taxation, as the chairman to determine the procedures and to rationalise the costs under the NHPS.
The NHPS is offering some 1,350 packages, including 651 super-speciality procedures and covering 23 specialities.
“The committee will now examine the packages, which is fairly comprehensive and choose the best options for the State. The Centre-State financing of the NHPS will be in the 60:40 ratio. The committee will also work out the costs and determine the approximate financial commitment of the State for the scheme,” a senior official said.