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 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 BJPled
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 universal
medical insurance offered by the government for free. The only
exception is for 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? Second, 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.
