PANAJI
Former Health Minister and Valpoi Congress MLA Vishwajit Rane on Friday lambasted the current government for failing to take forward the ‘Suvarna Jayanti Arogya Bima Yojana’ or universal medical insurance scheme which he had initiated towards the end of his tenure.
“We had started the universal medical insurance scheme and it had even taken off, but this government scrapped the scheme and after four years of trying, hasn’t been able to implement a scheme of its own,” Rane said.
When asked how his scheme was different, Rane said he had bought private hospitals on board and it was to be initiated through ICICI Lombard Health Insurance as the winning bidder.
“I tried to bring most hospitals under this scheme but our government was voted out before the scheme could be fully implemented,” Rane said.
Rane’s scheme offered to provide social security to the resident population of the whole of Goa by insurance coverage of upto ₹60,000 per family per year for meeting expenses of hospitalisation for medical and or surgical procedure including maternity benefits. However, its implementation was delayed.
It is as yet unclear how much ICICI Lombard had bid as a premium for per family to be paid by the government for the scheme.
Rane’s scheme was not perfect. There were several glaring discrepancies and instances where the same procedure had been entered in different places with different charges.
Besides that, there were allegations that the rates as per the scheme were not viable and barely 20 per cent of the private hospitals in Goa had registered.
The current government has been attempting to float its version of the scheme providing for ₹4 lakh insurance per year per family having three or more members and ₹2.5 lakh for a family having less than three members.
However after floating a tender on four occasions previously, the process failed to take off with the companies asking several questions to the government on the technical issues.
The approximate number of government employees in the State is 47,000. The data of identified beneficiaries along with the biometric data is to be handed over to the insurer by GEL.
There are also questions of a clause where in the government expects that if the Insured Claim Ratio (ICR) is below 80% then a part of the premium will have to be refunded.
The government has clarified that, “if above 80% no refund will be asked from the insurer but if ICR Falls below 80% in a year then 50% of remaining premium will have to be refunded".
Based on existing data, the approximate no of families in the State are 3,95,789. Out of these approximately 1,46,597 are families having 3 or less members and 2,49,192 having 4 or more members.
