It has been a four year struggle for the State government, and at the end of it, Goa still does not have a universal medical insurance scheme. The directorate of health services on Friday floated the tender for the fifth time and although the government has been announcing early dates for commencement of the policy, evidence on paper point to a much longer delay. The general view is, if the government could not put together a scheme in four years there is no compelling reason to believe that it will succeed in the next one year.
The medical scheme launched by the Digambar Kamat government in 2011 envisaged a cover of Rs 60,000 per year for each of the 3.5 lakh families. After the election of the new BJP-led government in 2012, the scheme was scrapped on grounds that it would have resulted in a loss of Rs 40 crore to the government and a new one “ Deen Dayal Swasthya Seva Yojana was announced. Under this new scheme a family of three would receive a cover of Rs 2.5 lakh per year while a family of four could avail of medical reimbursement to the tune of Rs 4 lakh per year. Then, it seemed like Goa was quickly turning into a welfare state. Four years and a lot of heartache later, the scheme is yet to take off.
Both schemes “ the one launched by the erstwhile government and the present one, have fundamental flaws. Firstly, they are free. Nowhere in the world is medical insurance offered by the government for free. The only exception is families below the poverty line. At present, the government finances and runs a public healthcare system that provides free medical aid to the public at minimal or no cost. What is the logic in providing free medical insurance over and above this? Secondly, what is the reason for extending this free medical insurance to the creamy layer of society?
A point over which the government needs to ponder is why is there no hue and cry over the failure of the medical insurance scheme? Why is not a single NGO or civil society group pushing the government to implement the scheme? It’s because it doesn’t really matter. The creamy layer has opted for medical insurance. Lower level workers have access to healthcare through the ESI scheme. Those who want free medical treatment have access to public hospitals. The Central government provides healthcare cover to poor and below the poverty line families through six schemes which, by and large, provide a cover of Rs 30,000 per year and the corporate sector has opted for group insurance schemes.
By attempting to provide a more popular scheme, the government has tripped and fallen four times and there is reason to believe that it will fall a fifth time on account of the inherent flaws in its approach to medical insurance. The vulnerable sections of society need access to better healthcare and a medical insurance scheme would give them access to the private sector which has proved to be more than a notch above public sector. To ensure that this section is served, the government first has to identify this sector and strengthen delivery of the existing schemes under the central government. It could add to this or bring in a new one, but the key to success lies in forging a partnership between the government and underprivileged people. Support those who are in need of help, instead of providing those who are better off with largesse.
