When the government of united Andhra Pradesh first introduced the Aarogyasri scheme in 2007, it was seen as a way for individuals below the poverty line (BPL) to access healthcare at private and government hospitals. The scheme provides coverage for services of up to Rs 2 lakh per family per year. Over 900 treatments are covered under the scheme and the procedures that fall under the scheme are done without cash payment if the individual is insured. The government will disburse the amount to the hospital concerned when the individual provides the relevant documents.
When the scheme was introduced in 2017, an amount of Rs 1,500 crore was allotted. Following the bifurcation of the state into Andhra Pradesh and Telangana in 2014, Arogyasri scheme became the responsibility of the government of Telangana, while a similar scheme called Dr NTR Vaidya Seva was introduced in Andhra Pradesh.
However, of late, private hospitals have been turning away patients who are covered under the scheme, alleging that the Telangana government has not reimbursed them for the treatments provided so far. This has once again resulted in a rift between hospitals and the government.
Around 200 private hospitals under the Telangana Aarogyasri Network Hospitals Association (TNHA), which oversees the implementation of the Aarogyasri scheme, had protested the delay in the payment by not accepting patients who have availed the scheme, ultimately leaving the latter in the lurch. Although the protest was called off, the doctors are now seeking a permanent solution, without resorting to protests time and again.
â€śAarogyasri is, no doubt, a wonderful scheme to provide healthcare to those living under BPL; it ensured that no one would be turned away from availing any healthcare. But how fair is it to expect doctors and hospitals to continue providing treatment without paying them for their services?â€ť an emergency physician at a private hospital in Hyderabad told TNM on the condition of anonymity.
She is not the only one to voice this concern. Several doctors have also appealed to the government to settle the dues so that services can be continued to be provided to those availing the scheme.
â€śOur working hours are excruciating and the workload is overwhelming. Making money is not every doctorâ€™s only priority. We have to be compensated for the work we do to provide for ourselves. While we appreciate the scheme, it is ultimately the doctors and the hospital staff who suffer when reimbursements are not made in time,â€ť says another doctor from NIMS hospital in Hyderabad, who did not want to be named.
The underlying issue
A month ago, the Telangana Aarogyasri Network Hospitals Association had sent a memorandum to Health Minister Etela Rajender, appealing to him to clear the dues. However, the amount has not been released yet, says T Hari Prakash, secretary of TNHA.
â€śThe government has not made the payment to some hospitals for over 14 months. When this is the case, how can these hospitals continue treating patients under the scheme?â€ť he asks.
â€śThis isnâ€™t the first time that we are protesting. We have raised questions or protest before and every time we do so, they (the government) announce that some amount of the money will be released,â€ť adds Hari Prakash.
After the five-day protest, the government finally, on Tuesday, announced that it would release an amount of Rs 360 crore towards the reimbursements.
â€śUnless there is a protest or outcry, the government does not do this. However, they have not found a permanent solution to this issue yet. If they did, we would not have to keep fighting over this,â€ť says Hari.