05 April 2010
By Durgesh Nandan Jha
New Delhi, India
To provide Delhiites with easy access to advanced medical treatment, the city government is all set to introduce a healthcare insurance scheme that will cover critical illnesses. The scheme – to be implemented from July 2010 – will be called Apka Swasthya Bima Trust (ASBT), which will be headed by Delhi chief minister Sheila Dikshit.
According to Delhi health minister Kiran Walia, the process for identifying target population, private partners and sources for funding the scheme has already been initiated. Walia plans to visit Andhra Pradesh soon to study how a similar scheme is being implemented in that state. The Aarogyasri Trust of Andhra Pradesh runs a susidized healthcare scheme under which healthcare solution is offered to those suffering from critical illnesses of the heart, kidney, brain, and cancer, etc.
“Most of the currently operational government–sponsored health insurance schemes – for instance, Rashtriya Swasthya Bima Yojna (RSBY) of the Central government – cover common ailments and are limited to primary and secondary healthcare requirements. The new scheme will address the need for tertiary and superspecialty healthcare. Initially, BPL and other vulnerable sections of society will be covered under the scheme. Later it may be expanded to cover all citizens,” said a senior health officer involved with the project.
The first meeting of the governing board of trustees of ASBT was held on February 19. At the meeting the trustees opined that the current RSBY scheme, which covers 2.64 lakh families in Delhi, should be integrated with the ASBT. Under RSBY, hospitalisation benefits up to a maximum of Rs 30,000 per family per annum is provided. Delhi government is mulling to increase the coverage of hospitalisation expenses up to Rs 1.5 lakh per family, sources said.
“Pre–existing diseases and day–care treatment will be covered under the new scheme. The suggested critical illnesses that are likely to be covered under the scheme may include cardiac surgeries and therapy, pacemaker implants, cancer therapy, neurosurgery and other surgeries”, said Walia, who is the vice–chairperson of the trust. She added that a health fund might be created for the scheme, for which funds would be tapped from Central government, Delhi government, revenue received from user charges and insurance reimbursements to public hospitals.
Delhi government is currently running a similar scheme called Delhi Arogya Nidhi under which BPL patients get assistance for treatment of life–threatening diseases. But they can go for treatment in government hospitals only. Under the new scheme, patients can go to certain private hospitals for treatment. “The performance of Delhi Arogya Nidhi scheme has been dismal due to the cumbersome procedure for getting the grant for treatment. The patient invariably incurs expenses from his own pocket before he receives the grant. In the follow–up treatment, the beneficiaries receive support for one year only,” said a senior government official.
Everyone To Benefit
- Apka Swasthya Bima Trust | A Delhi government project under which health insurance will be given to citizens
- To start from | July 2010
- Beneficiaries | ASBT will first cover BPL and economically weaker sections and later be extended to all sections of society
- Hospitalization expenses of up to Rs 1.5 lakh per family
- Pre–existing & daycare diseases
- National Rural Health Mission
- Revenue from user charges and insurance reimbursements to public hospitals
- Delhi Arogya Nidhi (Delhi Illness Assistance Fund)
- Special budgetary provisions of the government
Cardiac surgery, angioplasty, valve replacement, pacemaker implantation; cancer therapy, surgery and transplant; renal therapy, surgery and transplant; neurosurgery; burns; accident and trauma surgeries