Telangana Health Schemes on the verge of collapse
Telangana’s health insurance schemes, including Aarogyasri, EHS and Aarogya Bhadrata, face a crisis due to pending payments. Hospitals demand Rs 1500 crore
Hyderabad: Telangana’s flagship health insurance schemes, including the prestigious Aarogyasri, Employee Health Scheme (EHS) for government employees and Aarogya Bhadrata for police personnel, are on the verge of collapse.
A mounting debt crisis, caused by the State Government’s constant inability to clear pending medical bills and provide full support, has left the health insurance schemes unable to deliver proper quality healthcare to beneficiaries.
On Friday, the flagship health insurance scheme received another jolt with reports that the Aarogya Bhadrata scheme has been stopped for private hospitals, with NIMS being selected as the nodal hospital for beneficiaries.
In September, the Telangana Aarogyasri Network of Hospitals (TNHA) launched a major strike by boycotting all their services, demanding immediate release of Rs 1500 crore in pending funds that have been due for one year.
While the State government managed to convince the protesting hospital managements to call off their boycott, the pending medical bills are still not cleared.
“The State government promised to release Rs 100 crore every month, but they have not fulfilled their assurances. For August, they released Rs 80 crore, for October Rs 50 crore, and nothing in the months of November and December. There is no proper support from the State government for the Aarogyasri scheme,” senior doctors familiar with the issue said.
Public health specialists who have been tracking the development of Aarogyasri since its start said it is the most economical scheme, aimed at providing high-end tertiary care to poor patients.
“Roughly, the annual health budget for Telangana has hovered between Rs 12,000 crore and Rs 12,400 crore. To sustain Aarogyasri and allied health schemes, Rs 80 crore per month is needed, which is just a small part of the overall State budget. This is the most economical scheme to provide emergency relief to patients. And yet, no priority is given for payment of medical bills to hospitals. There is a limit even for private hospitals in financially stretching themselves to accommodate Aarogyasri patients,” a senior public health expert, on condition of anonymity, said.
Senior officials familiar with the Aarogyasri insurance said that since the government is unable to pay bills of Aarogyasri and EHS, it would be better to attach these two schemes, just like Aarogya Bhadrata, to NIMS.
DSP (Welfare) K Srinivas Reddy on Aarogya Bhadrata
Deputy Superintendent of Police (DSP) Welfare K Srinivas Reddy on Friday said that Aarogya Bhadrata health services for police will continue to be available in all private hospitals and Nizam’s Institute of Medical Sciences (NIMS).
For medical treatments that cost more, the entire cost can be availed free of charge at NIMS under the state-run Aarogya Bhadrata health insurance scheme.
“Police officers can receive treatment worth up to Rs 5 lakh to Rs 7.5 lakh at corporate hospitals for medical services. For their family members, treatment up to Rs 1 lakh to Rs 2 lakh can be availed, and this limit can be used multiple times within a year. For treatments costing more than this amount, the entire cost will be covered at NIMS Hospital under the Aarogya Bhadrata scheme,” DSP (Welfare) said in a statement on Friday.
Additionally, if long-term treatments with high costs are sought at NIMS Hospital, the full amount will be paid by Aarogya Bhadrata. Furthermore, ailments not currently covered in private hospitals can also be treated at NIMS, he clarified.
In a statement, the DSP (Welfare) advised police personnel not to follow rumours circulating on social media that the Aarogya Bhadrata scheme will only be available at NIMS Hospital. Treatments under the scheme continue as usual in corporate hospitals, he added.