State Health Insurance Scheme: With Premium Hiked Again, Number Of Beneficiaries Decrease
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13 May 2010
By Raakhi Jagga Abohar
THE health insurance scheme started by the state government under the aegis of Bhai Ghanaiya Sewa Society seems to be flawed.
It was first introduced in 2006 as Sanjivini Health Care for members of co–operative societies in villages, with an annual premium of Rs 330 and health cover of Rs 2 lakh per annum. Now, while the premium has been increased to Rs 2,215, the annual health cover has reduced to Rs 1.5 lakh.
As a result the number of beneficiaries have reduced from 5.9 lakh in 2006 to 2.82 lakh at present.
The premium was hiked from February this year and the new cards will be valid till January 31, 2011. With major hospitals includ ing DMCH and CMCH in Ludhiana and Fortis and Escorts in Amritsar excluded from the list of hospitals under the scheme, the beneficiaries have decreased.
Also, many applicants have still not received the health cards and at the same time many co–operative societies have received as many as three cards for one farmer.
Abohar MLA Sunil Jakhar said, “The scheme worked well till 2007 but was later discontinued. It was re–started in 2009 but the premium for members was increased to Rs 1,401 per annum. It has been further increased now.” In 2009, the annual premium for dependents up to 55 years of age was Rs 141, for dependents between 55–70 years it was Rs 211 per annum and for those above
the age of 70 it was Rs 284.
Now, dependents of 45 years or less have to pay Rs 331 per annum, those in the 45–65 years age group have to shell out Rs 661 per annum and more than 65 years have to pay Rs 882 per annum.
Jakhar said, “ The government is charging exorbitant premium, In 2006, the rate of premium for two age groups was Rs 33 and Rs 50.” CEO of Bhai Ghanaiya Sewa Society K S Pal has a different story to tell. He said, “In 2006, when the scheme was started companies did not know what outcome to expect. We had paid them Rs 8 crore as premium while Rs 40 crore were spent for treatment under the scheme, leading to huge losses. In 2009, we decided to float tenders.
Though the companies hiked the
premiums, we chose the lowest amount. Even after paying Rs 32 core as premium they suffered losses as cashless treatment alone was for Rs 40 crore. So this time the companies have increased the premium again. Members have already availed cashless treatment worth Rs 7 crore.” Pal said anomalies in the cards are being corrected and even if someone has received more than one card, their ID number remains the same. He claimed that distribution of cards had been done in all societies.
Regarding the amount of health cover, he said, “We found that people availing facilities of more than 1.5 lakh per annum were not more than 50 in number and hence we reduced the cover amount.”