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The Government of Andhra Pradesh has introduced an excellent health insurance scheme for all family members in BPL category. Mere possession of Ration Card (White Cards) is enough eligibility. Government pays consolidated insurance premium to Star Health. A network of 360 hospitals has been enlisted for availing treatment. 940 surgical and other procedures, primarily taking care of operations for Kidney, brain, heart, cancer, Burns etc are covered. Accidents coming under Motor Vehicles act are out of scope in this scheme. A large number of Aarogyamithras have been appointed within the easy reach of villagers whom can be approached for information, explanations, help, liaison, complaints etc. The whole system is totally cash less. Just enter the hospital with your Ration Card and special Aarogyasri card, get treated and walk away. Operations costing about 1.5 to 2.0 lakhs are done free to members of BPL category. The website of the scheme gives a lot of details. For instance on 1st April 2011, we know how the scheme performed: 26000 medical camps were held, 4.4 million persons were screened, 40 lakh were treated, 10 lakh surgeries / procedures performed and about Rs 2920 crores worth claim disbursement (direct payment to hospitals by Insurance Company) was approved. These are cumulative data. We get monthly data also. Now the scheme covers whole of AP. It has won several acclaims and awards. Karnataka has shown interest in replicating it. Such a wonderful scheme will be a boon to senior citizens. Senior citizens under BPL are automatically already covered. Senior citizens APL (Above poverty line) are worst sufferers when it comes to health. Diseases are more, money available for treatment is less, no earnings except meager pensions are some problems faced by this group. Moreover most Health insurance schemes have become unaffordable to most senior citizens. Above a certain age (when they need it most) senior citizens are simply denied any Medical / Health insurance at all. After 85 one can not get any insurance extended. Aarogyasri should be extended to Senior Citizens in APL Above Poverty Line category too. They may be asked to pay the premiums themselves. The premium is likely to be very affordable as large numbers are involved. This will be a great boon to the silently suffering community. An authenticated, verified Voters List could form the basis for negotiating with the Insurer. Voters ID card or Aadhar card may be used for gaining access to the facilities. I wish some political parties include this in their agenda for the coming elections. They will gain the sympathy and support of senior citizens. After all senior citizens constitute more than 8% of the population. Some states like Tamilnadu and
Pudhucherry have already started recognizing Senior Citizens as a part of Vote Bank. ==========================
"Indira Jai Prakash, Bangalore University" <indira313@hotmail.com>, Padmanabha Vyasamoorthy <vyasamoorthy@gmail.com>, "AM Khan, NIHFW" <m_khannihfw@yahoo.com>, "Prof.Kalluri S.Rao" <ksrsl@yahoo.com>, "Seema Puri, IHE" <dr.seemapuri@gmail.com>, Shankar Kinjawadekar <drspkinj@gmail.com>, Ramanbhai Shah <caprachimshah@gmail.com>, Krishnaswamy B <bksgerio@yahoo.co.in>, Gangadharan K R <krg.nascai@gmail.com>, Chapke D.N <dnchapke@yahoo.com>, RN Mital <rnmital@gmail.com>
Subsequent to Prof Indira Jayaprakash asking us to send our comments on Health care of the Ellery, I have not seen many replies exchanged amongst ourselves. Some may have sent their comments directly. I suggest that we try to push just one point vehemently across, as far as NPSC - 2011 is concerned. In the policy in paragraphs on healthcare only universalisation of RSBY is mentioned. The draft is already with the minister. Before it gets his final nod, we need to send in our comments. I am giving below a small table comparing important features of RSBY and Aarogyasri. A quick glance will tell us why we should push Aarogyasri against the ill advised RSBY. ==
Total cases (benefited )about 17 lakhs Premium: Central govt 75% State government 25% Registration charges paid by Family Rs 30 per year; Each family is given Biometric ID card Premium paid to Insurer: Varying from Rs 500 to To 850 per family (district is the unit); So far 376 districts are covered out of which 214districts have completed enumeration of BPL family data. Pre existing diseases are covered 8104 hospitals in 376 districts of 26 states Many insurance companies are involved; However in any one district only one insurer is allowed. Cashless reimbursement of expenses; paid directly to hospitals; No follow up related payment ??
430 lakh screened; 37 lakhs cases registered Entirely from State funds ?? No Registration charges; Based of White Ration card, Aarogyasri card is issued Premium paid: about Rs 530 per ?? What could be the likely family; complete data base of 800 premium if APL families are lakh people and 200 lakh BPL included and sharing of premium families with digital photo, socio is accepted in principle? economic data + iris biometrics available Pre-existing diseases are covered Important for Senior citizens 333 Hospitals networked only in AP One insurer for entire state ??
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Cashless reimbursement of expenses; paid directly to hospitals; Cashless Follow up expenses after operation for one full year is also given Very robust IT infrastructure / Website is accessible to all; system which acts as the plenty of info to verify; backbone of success; 24X7X365 RGBS website gives scanty info; instant info / follow up are possible 942 procedures covered thro RSBY does not give data insurer; 612 procedures covered by direct reimbursement of money by Aarogyasri trust to patient Screening camps are integral part Screening & prevention most of Aarogyasri important Training of all levels / types of No provision in RSBY personnel
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Feedback; monitoring; preventionIn RSBY, Everything is left to of abuse; are al integral part of State and district level the system administration; Commitment levels will vary so the results will be. Proper implementation should be in the hands on one organisation as in Aarogyasri
Any comments? Kindly send them to Chairperson. Dr P Vyasamoorthy, 30 Gruhalakshmi Colony Secunderabad 500015 Ph 040-27846631 / 9490804278.My blog: http://vyasa-kaaranam-ketkadey.blogspot.com/