When a 50-year-old farmer from Ramanagaram came to a private hospital on Hosur Road last week for treatment, little did he know that his Yeshasvini health scheme card was no longer valid. He was surprised when he was told that he needed to have a BPL card and Aadhaar card or Arogya Karnataka card along with a referral letter from a government hospital to avail free treatment.
There are several patients like him, who are unaware about the mandatory rules of referral system from a government hospital and BPL, Aadhaar cards for availing benefits under the recently launched Arogya Karnataka scheme.
Even patients who are visiting the State-run Sri Jayadeva Institute of Cardiovascular Sciences are under the assumption that their Yeshasvini card will work.
“Although there is no need for a referral from here to a private hospital as the institute has all facilities to provide complex and tertiary treatment, it is mandatory for the patient to have a BPL, Aadhaar card or Arogya Karnataka card. This has led to problems as Yeshasvini card holders are both from the BPL and APL category,” said C.N. Manjunath, Institute Director.
Although the scheme was launched in a hurried manner just before the elections, the rules and guidelines for its implementation were framed only after the new government took over. While there was a demand from farmers to continue with Yeshasvini (the scheme lapsed on May 31) and the Chief Minister had also assured them that he will look into it, all the six health schemes, including Yeshasvini, have been subsumed into Arogya Karnataka.
The only exception is for the 62 lakh families who hold Rashtriya Swasthya Bima Yojana (RSBY) cards. These families can avail RSBY secondary treatments in the empanelled hospitals without any referral from a government hospital till August 31, based on their RSBY cards.
Former president of Private Hospitals and Nursing Homes’ Association (PHANA) S.C. Nagendraswamy said hospitals too are in confusion now. Moreover, there is no clarity on rates for various procedures as the prices are yet to be fixed. “They had asked us to recommend names for the rate fixation, infrastructure and clinical practices committees. We have sent the names in the last week of June and still waiting to hear from the government,” he said.
C. Jayanna, PHANA president-elect, said in the absence of clarity on guidelines and rates, private hospitals are facing the wrath of patients who directly come to a private facility without a referral.
“The confusion is because of low awareness and lack of clarity in the guidelines. Unfortunately, the patients blame us and not the government for the mess,” he said.
Admitting there are issues related to the implementation of the scheme, Puspharaj S., Director, Health and Family Welfare Services, said: “These are teething problems and we are aware of the issues. We are working on further simplifying the guidelines to ensure that the scheme is beneficial for all.”