Mysuru: The much anticipated universal health coverage scheme launched by the state government, ‘Arogya Karnataka’ launched in March appears not to have been the panacea for the underprivileged communities it was expected to be when it was conceived. Many citizens are finding transitioning from the erstwhile Yeshasvini Health Scheme to the new one is proving to be far from seamless.
Neither the citizens nor the authorities concerned appear to be well acquainted with the nitty-gritty of the new scheme, which only serves to be compounding the woes of the patients. Meanwhile, private hospitals are also confused about the details and have complained of being under pressure from patients belonging to the
below poverty line (
BPL) category, who are entitled to 100% reimbursement. However, many patients who have been grouped under
Above Poverty Line (
APL) are dissatisfied with the fact that they can avail of only 30% compensation.
One of the most common grievances heard from patients at Krishna Rajendra (KR) Hospital on Wednesday was the lack of clarity on the procedures to be followed at private hospitals for free. Confusion abounds questions over the necessity of an
Arogya Karnataka card to receive treatment at private hospitals. Moreover, BPL patients also expressed their unhappiness with the cards not being distributed at KR and Cheluvamba hospitals in the city.
Rajashekar, 41, a resident of Sargur, was waiting near the outpatient ward of KR Hospital. Diagnosed with a strain of gastrointestinal disease, doctors in Sargur suggested that he visit the city to undergo a series of tests, and if necessary, a surgery. “I have a BPL card. But, treatment is free in city hospitals under the
Yeshasvini scheme. Now, they are refusing to admit me, and are asking for a letter. But we have to wait in a long queue to get the letter, and we are not sure if the tests and surgeries will be performed at KR Hospital, or if we will be referred elsewhere,” said Rajashekar.
His was not an isolated case. Sangeeta, 34, the mother of an 18-month-old child is apprehensive about undergoing treatment at a government hospital expressing concerns over hygiene. Explaining her predicament, Sangeeta said, “My husband is not paying for my treatment because of some family issues. I cannot depend on my parents. Under Yeshasvini scheme, we had the option of selecting a hospital of our choice. When I underwent a Caesarean surgery at a private hospital, I got some concession. The government must improve facilities at its hospitals before asking us to take treatment here.”
On the other hand, Revati, daughter of one of the patients at KR Hospital, pointed to the disjunct between media reports and the reality at the healthcare institutions. “While we read that cards are being distributed at all district-level hospitals, the authorities here are telling us that the process is yet to start. We are also unaware of the procedure involved in getting a letter from the doctor here that we can take to private hospitals,” said Revati, who echoed Sangeeta’s concerns about lack of cleanliness and level of hygiene at government institutions.
‘Patients not aware of Yeshasvini is no longer valid’
Manager of a private hospital in the city said that many parents appeared not to be aware of the fact that Yeshasvini scheme was no longer valid, and had been replaced with the Arogya Karnataka initiative. “They are knocking on our doors and are requesting treatment under the old scheme. Convincing them about the need for a letter from the government hospital to receive treatment here has become a big headache,” he added.
The manager pointed out that the benefits of five schemes had been merged under Arogya Karnataka, and that network hospitals were referred only for specific procedures and treatment. “Patients from lower middle-class families are not ready to visit government hospitals, and have many misconceptions about the same. They pressure us for referral letters, which we cannot provide. Yeshasvini scheme must be implemented at least for APL patients,” he said.
Understandably, APL cardholders are none too pleased with the change. Pointing to the loss of benefits that they availed of easily under Yeshasvini scheme, wholesale vegetable vendor at Devaraja Market Jagadish Kumar said, “Under the old scheme, we had the option of choosing a hospital from the network. At local hospitals too, we could always request doctors to perform an operation for a certain amount. Now, the authorities are claiming that, under Arogya Karnataka, only 30% of the expenses will be paid to APL card holders.”
Fears among patients unfounded: Implementing agency
Seeking to assuage the doubts and reservations in the minds of patients about the feasibility of the new scheme, Dr Prasad of Suvarna Arogya Trust, a government agency that has been entrusted the responsibility of implementing the
Arogya Karnataka scheme, said that beneficiaries could avail of free treatment at private institutions without a referral letter from state-run clinics at the time of emergency situation. “Cards are being distributed to all patients, who are being admitted to government hospitals,” said Dr Prasad.
Highlighting the benefits of the new scheme, Dr Prasad said, “Under the Yeshasvini scheme, family members had to pay a premium sum for each member. But, under the new initiative, there is no premium. Treatment is provided free of cost to BPL families at private hospitals, while the others will have to pay only 70% of the bill.”
He added that, under the scheme, diseases were classified under multiple categories. “Patients who need to undergo surgeries for minor problems such as hernia will not be referred to private hospitals. We will provide referral letters depending on what disorders and diseases can, and cannot, be treated at government hospitals,” Dr Prasad told TOI.
Stating that cards were not necessary for all patients, he said that they would be given one for Rs 10 on admission to a government hospital. “If they lose it, they can get a duplicate for Rs 20. We will soon start distributing cards at KR and Cheluvamba hospitals. In Mysuru, we will refer patients to private hospitals for those diseases that cannot be treated at government institutions,” Dr Prasad said.
