Just when one thought the Deen Dayal Swasthya Seva Yojana (medical insurance scheme of the State government) was dead because it offered no real health benefits
to the aam aadmi, Deputy Chief Minister Francis D’Souza has breathed some life into it. Out goes the principle of protecting the Goa Medical College and in comes the business
needs of private hospitals. D’Souza told the Assembly that the government has taken an in-principle decision to extend all 447 procedures to the private sector. Initially, the government had announced that the scheme would cover 276 procedures, which would be made available in the GMC, while 147 procedures would be open to the private
sector. This caused a lot of heartburn in the private sector
which found itself left out. The one disturbing question
that the scheme raised is, why is insurance cover required for
procedures in the GMC, which are already free? Hard pressed
to answer this one, the government came out with an equally
disturbing answer that once the
scheme is launched, all treatment
at the GMC would be paid-for.
In its early avatar, the scheme was
not a game changer. Why would anyone
want to stand in a queue to get
registered for a scheme that turned
free treatment into paid treatment
and then made it free again through
insurance cover? The general perception
was that the government was taking money from one
pocket and putting it into another. The real game changer
would have been an offer of free treatment in private hospitals.
With very few people queuing up to get themselves registered,
the government realized that the scheme was not the
vote catcher it was thought out to be. It went back to the drawing
board and recast the scheme to include the private sector,
something that everyone, except the GMC, wanted. This
should have been the way to go in the first place and it appears
good sense prevailed. D’Souza told the House that the scheme
is still a work in progress and more changes would be or could
be made so that the end results benefits the aam aadmi.
The private sector will stop having sleepless nights, but one
crease that needs to be ironed out is rates. In earlier discussions,
representatives of the private sector had argued that it
could not adhere to the rates specified in the scheme without
incurring huge losses. What they suggested was a free regime
where they would fix the rates and the insurance scheme
would only cover a portion of the cost. This would give the
aam aadmi a choice but still make GMC a cheaper option. It
seemed like a win-win situation for the public and private sector.
Let’s hope it works as well in practice, as it looks on paper.
