Patients seeking specialised treatment under government-run insurance schemes in over 300 empanelled private hospitals in the State have been left in the lurch with the stalemate between private hospitals and the government continuing.
Upset with the outstanding dues of over Rs 110 crore from the State Health Department-run Suvarna Arogya Suraksha Trust (of which nearly Rs 40 crore was released recently) and misuse of below the poverty line (BPL) cards, the empanelled private hospitals had threatened to discontinue enrolling new patients from January 16.
The hospitals, which are members of the Federation of Healthcare Associations (FHA) – Karnataka, a consortium of Registered Private Hospital Associations in Karnataka formed recently, demanded that their dues be cleared without any further delay.
Following this, Health Minister K.R. Ramesh Kumar convened a meeting with FHA representatives and assured them that their dues will be cleared within 15 days. He also promised to set up a committee to look into their other issues of unscientific price fixation and misuse of BPL cards. However, the hospitals claim that despite several such assurances in the past, nothing has actually happened.
“We have not got any written official communication from the Minister. Moreover, we never agreed to continue treating patients in the existing scenario — with existing prices under the schemes and with the outstanding dues. The Minister assured us a committee would be set up and we requested that our members should also get representation in the committee, to which he agreed,” said Madan S. Gaekwad, FHA member and president of the Private Hospitals and Nursing Homes Association.
He said apart from pending payment, a major concern was the “gross misuse” of schemes by non- BPL patients because of “indiscriminate issuing of these cards”.
“When the schemes were launched, only 27 per cent of the State’s population was categorised as below the poverty line. That is why we agreed despite the low package costs. But, now, unfortunately, eight out of every 10 people come with one or the other health card (BPL, Yeshaswini, Rashtriya Swasthya Bima Yojana) to avail themselves of benefits under the schemes. Private hospitals cannot treat 80 per cent of the population at subsidised rates,” he said.
Due to this, both the government and private hospitals are facing losses as the scheme benefits are not reaching the genuine BPL families, the doctor added.
S.C. Nagendra Swamy, principal coordinator FHA-Karnataka, said for the last seven years there had been a minimal revision in prices paid for various procedures for these schemes despite the rising costs and inflation. “Unscientific price fixation, introducing new terms and forcing new schemes on the existing providers in the middle of the contract are our main concerns,” he said. Mr. Gaekwad said that in the interest of patients, they had not stopped treatment for existing in-patients availing benefits under the government insurance schemes, emergencies, accident victims and children. “Patients have not been hit as the procedures under the scheme are only elective surgeries,” he said.