Editorial

Insurance-driven healthcare hasn’t worked for Covid-19

| Updated on June 03, 2020 Published on June 03, 2020

The limitations of insurance approach have come to the fore even in the US. Public-funded care is the answer

The treatment of Covid-19 was brought under ‘Ayushman Bharat’ (or the Pradhan Mantri Jan Arogya Yojana) exactly two months back, and yet complaints of patients being overcharged by private hospitals continue unabated. Taking a serious view of the issue, the Supreme Court last week asked the Centre to identify hospitals where Covid-19 patients can be treated free or at minimal cost. The PMJAY scheme, launched in September 2018, is meant to provide a cover of ₹5 lakh per family per year to 500 million people. It appears that a quarter of this coverage has been accomplished so far. Given this level of coverage, the Centre must issue clear directives to ensure that private hospitals keep their doors open to Covid patients. So far, the absence of clear guidelines has led to a state of confusion, putting a disproportionate burden on the government healthcare system.

It is not clear what percentage of India’s ₹2.4 lakh crore private health sector, that is estimated to account for three out of every four hospital beds in India and eight out of ten ventilator hospitals, has stepped up its operations. Experts argue that only 10 per cent of the Covid-19 patients have been treated by private hospitals. Meanwhile, Centre and State government orders on roping in private hospitals have been tardy, if not pointless. On May 29, the Delhi Government requisitioned the services of five hotels to be attached with five private hospitals. The order caps rates at ₹5,000 per day as room rent in addition to hospital/investigation services as also ₹2,000 for oxygen support per bed per day. Who picks up the tab here is not clear; for even the well-off, this is a tall order.

Meanwhile, patients suffering from diseases other than Covid-19 have been abandoned, being unable to access hospitals. Data from the National Health Authority (NHA) that manages the PMJAY indicates that the number of treatments for as many as 825 types of unique non-Covid procedures by both private and government facilities dropped over 20 per cent between February and April. The number of procedures performed in these packages came down to 1,51,672 in this two-month period from 1,93,679. Cancer-related procedures dropped around 57 per cent between February and April, cardiology by 76 per cent and procedures in obstetrics and gynaecology were down nearly 26 per cent. Notably, ischemic heart diseases kill as many as 4,000 people in a day in India, chronic obstructive pulmonary diseases (COPD) take 2,600 lives daily, cancer kills about 2,200 Indians — and nearly 2,000 die of diarrhoea and 1,200 from tuberculosis every day in India. Clearly, there are limitations to an insurance-driven approach; this has come to the fore even in the US. There can be no alternative to State-funded healthcare, for which the funds must be set aside.

Published on June 03, 2020

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