Miffed by the Karnataka government’s indefinite delay in paying its dues towards the Vajpayee Arogyashree Scheme (VAS), private hospitals in the state have decided not to admit patients under the scheme from Monday onwards.
According to private hospitals, not only has the government defaulted payments for the past six months, but has also turned a blind eye to their consistent demands for rate revision.
Implemented in 2010, the scheme is directed at providing high-end treatment to BPL families in super-specialty hospitals. It is being implemented under the aegis of Suvarna Arogya Suraksha Trust, a body under the Health and Family Welfare Department.
According to data available with the department, over 1.29 lakh people have benefited of the scheme in Karnataka since 2010. While 43,577 benefitted for the year 2014-2015, the number stands at 28,720 until November 2016.
According to a report in The Hindu, the state government released ₹1,005.79 crore from 2009 towards VAS and two other schemes- Rajiv Arogya Bhagya (for APL patients), and Jyothi Sanjeevini (for government employees).
According to representatives of various associations that are part of the consortium of Federation of Healthcare Associations (FHA), the government owes nearly Rs 100 Crore to the various private hospitals in the state.
The state recently released Rs 34.25 Crore to the private hospitals, after they threatened to stop admitting patients under the scheme.
What are the private hospitals demanding?
FHA has stated that private hospitals in the state will not admit any patient under the VAS scheme starting Monday. The association is scheduled to meet state Minister for Health KR Ramesh Kumar on Monday, to sort out the issue.
Speaking to The News Minute, Dr Yusuf Kumble, President of Nursing Homes and Hospital Managements Association, Dakshina Kannada, said that the government owes nearly Rs 60 Crore to as many as 11 super-speciality hospitals in Mangalore alone. Out of the 80 hospitals in Mangalore, only 11 are equipped to admit patients under VAS.
“The government is entitled to address our concerns regarding the cost. For one, they are paying us the same amount they pay government hospitals. They are not taking into account, the procedural cost that we incur. They are giving us not more than 20% of the cost we spent on the treatment. We cannot compromise on the quality of treatment based on the financial standing of the patient, can we? On top of this, they are not even paying up on time,” Dr Yusuf said.
Saying that the onus of giving super-specialty treatment to the people lies with the state government, Dr Yusuf said that if the private hospitals have been roped in to give advanced treatment that the government hospitals fail to provide, the least the government can do is to cover the cost on time.
“The government is pushing the people to get admitted in private hospitals. Once they are admitted, we have the responsibility to treat them properly. All we are asking is that the government should pay for at least 70% of the cost. We are not asking for any profit here. We are completely aware of our social responsibility,” Dr Yusuf assured.
Asked whether refusing to admit patients will ultimately harm the patients, Dr Yusuf, who is also the managing director of Indiana Hospital in Mangalore, said that the hospitals have opted for a “treat-or-don’t-treat” policy.
“We will not refuse treatment to the patients already admitted under the scheme. They will continue to avail our services until they get discharged. If we admit them, then we are entitled to give them proper treatment. Either you treat them properly or don’t treat at all,” Dr Yusuf said.
Nearly 50-100 patients are admitted at the hospital under VAS every month.
Dr Madan Gaekwad, executive vice-president of Sagar Hospitals, and president of Private Hospitals and Nursing Homes Association (PHANA) maintained that no emergency cases will be turned down. Nearly 400 private hospitals in Bengaluru are part of PHANA.
“At no point, have we said that we will deny treatment to emergency patients. The patients who avail VAS are elective cases, where they can choose to get treated any time,” he said.
He feels that the government is making an attempt at portraying the private hospitals as lacking social responsibility by closing its doors to patients below the poverty line.
“Our second demand is for increment of the cost, that has been standard ever since the scheme began seven years ago. They should increase at least 25% of the cost, as other expenses have also gone up. It is only reasonable to ask for this,” Dr Yusuf explains.
“The prices of the consumables are going up, the salaries are going up, medicines are going up. But the government just refused to revise the rates. Another issue that we face is with regard to bogus cards. While the government say only 27% of the state is under BPL, a large number of the population still carry BPL cards. This puts unreasonable pressure on us,” Dr Madan said.
What's the solution?
The association, however, expects little to come out of the scheduled meeting on Monday with the minister.
“This minister is completely anti-doctor. The government will again reiterate its usual stand that they will clear the dues soon. But we want a written declaration as to when it will happen. We also want them to take a call on the rate revision,” Dr Yusuf maintained.
Following the meeting, the associations will take a call on the future course of action. A solution for the issue, they maintain, lies with the government addressing their demands.
“The issue was not as grave as it is now, it was smooth. We now want the Karnataka government to follow Tamil Nadu and Andhra Pradesh model, where electronic transfer of payments happen within days. Nobody who treats patients in TN has probably even seen where the government office is located, because it has been so smooth and prompt. If that can happen in our neighbouring states, why not in Karnataka?” Dr Madan said.
He feels that though the private hospitals voluntarily sign up for various government schemes, delays in releasing funds only discourages them.