Whither health in­sur­ance?

The Hindu Business Line - - THINK -

The poor sel­dom ben­e­fit as they aren’t aware of their en­ti­tle­ments

Call it coin­ci­dence or a strange turn of events. But to run into cab-driv­ers on two con­sec­u­tive days, both with a des­per­ate need of funds for med­i­cal treat­ment cer­tainly forces quiet re­flec­tion. Where are the gov­ern­ment-run health in­sur­ances and pro­grammes when needed the most?

The com­mon re­frain from pa­tient fam­i­lies from poorer eco­nomic back­grounds is of not be­ing aware of health in­sur­ances avail­able to them. Most of­ten, pri­vate hos­pi­tals do not tell them of their en­ti­tle­ments un­der Ayushman Bharat or the state-run health in­sur­ance. And why go to a pri­vate hos­pi­tal when gov­ern­ment-run hos­pi­tals prom­ise treat­ment for free or sub­sidised costs?

The re­signed an­swer al­most al­ways is, “no one cares for us at these hos­pi­tals.” On prod­ding for in­for­ma­tion, they nar­rate how peo­ple with lim­ited funds are of­ten “in­vis­i­ble” to staff in pub­lic hos­pi­tals and even if they do tend to them, there’s lit­tle en­gage­ment and even that is dished out like its a favour.

Peo­ple are of­ten asked to wait in long queues and come back the next day, after the wait. And if a CT scan or MRI is re­quired, the pa­tient would have to con­tend with long wait­ing lists be­cause there are few ma­chines, the ex­ist­ing ones are un­der re­pair or the staff has gone for lunch or worse on a month’s leave (this was an ac­tual ex­cuse one Mum­bai-based gov­ern­ment hos­pi­tal had made to a pa­tient fam­ily). And hos­pi­tals are woe­fully un­der­staffed to have a re­place­ment take charge. As a re­sult, the pa­tient is sent to a pri­vate hos­pi­tal and is forced to spend ₹7,000 for a scan, to start with.

If in­deed gov­ern­ments want to make their health in­sur­ance schemes ben­e­fi­cial, they need to make this in­for­ma­tion read­ily avail­able to all pa­tients en­ter­ing the hos­pi­tal. Maybe even have kiosks near hos­pi­tal front-desks staffed with peo­ple who can ex­plain to pa­tients how to nav­i­gate the maze called health in­sur­ance.

There will be a del­uge of help-seek­ers, and hope­fully it trans­lates into some­thing mean­ing­ful like cov­er­ing the pa­tient’s med­i­cal ex­pense.

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