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CHENNAI: The six-member committee appointed to probe the functioning of the Prime Minister’s Health Insurance Scheme is preparing a comprehensive report to be submitted by November, the Health Minister said. Ma Subramanian said. The committee is chaired by the former director of the National Health System Resource Center. Dr. T. Sundararaman visited several districts to understand how the participation of private hospitals could be strengthened and how this scheme could be scaled up, and he visited hospitals, doctors, paramedics, patients, He said he visited other relevant parties. The report will be submitted to Prime Minister MK Stalin soon. More than 1.4 billion households are enrolled in the program, according to state records. In all government hospitals and private sector competent hospitals, each family can receive up to 500,000 yen insurance annually for over 1,000 illnesses. But stakeholders – patients, hospital administrators and doctors – complain that the 14-year-old system not only denies and delays treatment but also puts pressure on government doctors. Some private hospitals had less than 10% of their beds reserved for patients under the insurance scheme. Forcibly take patients to government hospitals. The Tamil Nadu Government Doctors Association says this will increase pressure on government hospitals. The association is calling on the government to increase private sector participation. “Deliveries, for example, are not covered by the scheme. The state makes almost 60 per cent of all deliveries at GH. There are fewer than 2,000 gynecologists for around 550,000 deliveries.” said Dr. K. Senthil, president of the Government Medical Association. “Women also have to be sent to private hospitals,” he said. Systems for upper-middle and upper economic groups The committee is also considering options to make health insurance available to people across economic groups. The scheme is currently targeted at BPL households, with people from other income groups also participating. The committee is developing a strategy to determine whether people from upper-middle economic groups will be accepted. “The premiums for the poor will be paid by the government and treatment will only take place in general wards. People from other economic groups will be asked to pay higher premiums to participate in the scheme. Prices are voluntary. It depends on the type of room and equipment you have. Whether the beneficiary should pay part or all of the premium is still under consideration. As with all group insurance, premiums are paid by individual or family insurance. It will be cheaper in comparison,” said an official.
