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How Kerala is improving healthcare for the poor

November 09, 2010 08:40 IST
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Kerala has used the Centre's Rashtriya Swasthya Bima Yojana to the advantage of its government hospitals, says Sreelatha Menon.

Workers in the taluk hospital in Cherthala in Kerala got an unexpected bonus this year.

About Rs 25 lakh was divided among them as bonus for their service to patients who were treated under the centrally-sponsored Rashtriya Swasthya Bima Yojana.

The hospital is on its way to giving private hospitals in the locality a run for their money.

It has been able to spend roughly Rs 1.25 crore (Rs 12.5 million) on infrastructure this year due to payments by the insurance company, United Insurance in this case, for treatment of patients registered under the scheme.

In Kerala, about 130 government and an equal number of private hospitals are part of the scheme. In a unique initiative, the state decided to include below poverty line (BPL) people in its own list under the scheme. In other states, only BPL families in the Centre's list benefit.

Under the scheme, people pay Rs 30 premium for an annual cover of Rs 30,000.

While about 27 states have brought their BPL people under the scheme and are providing them smart cards, Kerala has gone a step ahead of the rest.

It has decided to also enroll the 1.4 million-odd people who are only in the state's BPL list. It is also the first to open the scheme for universal coverage. Now, anyone can get the cover by paying the entire premium of Rs 500.

For those in the Centre's BPL list, the state government and the Centre share the expense, while in case of the state list, the state labour department pays the extra premium over the Rs 30 that each family pays.

Since treatment is in general wards, this is supposed to be a deterrent for the not-so-needy from seeking smart cards, feel state officials. This will take the number of people covered in the state to about 3.5 million from April 2011.

This was made possible as Kerala decided to use the scheme to its advantage, unlike Rajasthan or Sikkim where the scheme has not even opened its account.

The scheme has managed about 20 million enrolments across the country, not bad compared to the biggest government scheme, the National Rural Employment Guarantee Programme, where 34 millon people hold job cards.

According to Kerala Labour Minister PK Gurudasan, transfer of data of those in the state BPL list was done through the 2,000 Akshaya centres. The scheme covers workers in almost all traditional industries like coir, fishing, cashew and tea.

Apart from the rapid expansion, one of the best indicators of the scheme's health is the fact that it has an in-built mechanism to detect frauds. This year, 60 hospitals were not included in the panel.

According to Anil Swaroop, director general, labour welfare, the moment a smart card is swiped in a hospital, the 12 insurance companies that are part of the scheme receive information so that they can cross-check.

The scheme is now trying to reach out to sectors like construction. The process is slow but the gains are visible.

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