Hyderabad: In a radical move, the state government has decided to reserve 132-odd routinely performed procedures under Arogyasri scheme for public sector hospitals and thus ensuring that the number of cases going to private hospitals drop significantly. To be implemented in a month or two, the landmark decision has come as a blow to the 340 Arogyasri empanelled hospitals in the state which will not be allowed to take up treatment of these 132 ailments. At least 50 of them are worried of an imminent closure. Most of these are B-grade 50-bedded hospitals that sprung up in the city over the last three years to live off the Arogyasri scheme.
With the government now battling to fund this health insurance scheme, hospital managements say they would be forced to shut down if the flow of Arogyasri funds stop, clearly indicating that they don’t really have patients other than Arogyasri cases. There are an estimated 50 such hospitals in the twin cities alone. Hospital administrators admit that a neat 40-80% of their business is Arogyasri funds-dependent. Most of the hospitals have come up on the city outskirts and some in the core city area over the last three years.
“This flagship scheme of the state government was launched to provide quality health care to the poor. After four years, they have now redesigned it in such a way that the original idea of the scheme has been totally diluted. These patients cannot get corporate care in government hospitals,” said a senior doctor heading an Arogyasri empanelled hospital in the city. He added that after encouraging the poor to go to corporate hospitals for four years and now forcing them back to government hospitals, the government is fooling them.
Opposing this move, experts note that it’s the poor patients who will suffer ultimately. “There is a threat of a huge waiting list at government hospitals due to this as the bed strength in these hospitals is poor. So patients would have to go to private hospitals and shell out money despite being covered under the scheme,” said Dr B Bhaskar Rao, president, AP Speciality Hospitals Association. He added that if the government implements this measure, many smaller hospitals may have to close down.
However, Arogyasri Trust CEO N Srikant told TOI that the procedures that would be reserved for government hospitals were identified by a committee for better administration and strengthening of government hospitals. “These identified procedures are those where there is scope for misuse or moral hazard. If entrusted to government hospitals, the misuse will not occur,” said Srikant adding that procedures including hysterectomy and appendicitis would now be reserved for government hospitals. Senior doctors at government hospitals lauding the move said that this would increase the revenue of the state run facilities. Ever since the scheme was launched, a majority of the patients have been going to private hospitals. Public hospitals see a 10 % jump in their revenue with this move.
“Had the government spent the same money on government hospitals, the quality and benefits for patients would have been 10 times better,” said R S Saluja, president-elect, AP Nursing Homes Association.
Now, the AP Speciality Hospitals Association is representing the government to increase the package rates by 20-25 %. “These rates were fixed some four years back. Now due to inflation, change in salary structure, power bill and cost of disposables have all gone up,” said Dr Bhaskar Rao, president of the association. He added that Rs 1,000 crore is not a big amount for the government to spend on health when it is spending Rs 4,000 crore on education. TOI