Muzaffar Ahmed Baba ran an automobile repair shop in Sopore. The 56-year old father of three, Baba earned reasonably enough to give a decent life to his family. But when he suffered a massive heart attack in 2017 summer, the life for him and his family turned upside down.
The family had to shell out over one lakh rupees for a stent to help Baba survive, even though the surgery was carried out at a government hospital. The expenditure cost the Baba family their entire savings.
Later, the frequent checkups at a private clinic in Srinagar further drained the family financially. With Baba still unable to return to work and his three children too young to earn, the family has become depended on the help by the relatives, and borrowings from the neighbours.
Last month, pushed into penury by his sudden health emergency, the family decided to sell their workshop.
Like Baba, thousands of people in J&K are pushed into poverty by health conditions and ailments. Many, with no monetary cushion to support the treatment expenditures lose the battle for life.
At SMHS Hospital, Mohammad Ramzan is one such patient, who is facing death because his family has been unable to arrange Rs 1.5 lakh to purchase pre-surgery drugs to cure his brain tumor.
Ramzan is a mason by profession, but the brain tumor has confined him to his bed.
Currently, 92.7 percent population in J&K does not have any health insurance cover as per data of National Sample Survey Report (71st round). This implies that about 93 percent people in J&K have to spend out of their pocket on healthcare, and that a health emergency may translate into a financial catastrophe for this majority.
According to experts, had the GoI sponsored health insurance scheme Rashtriya Swastha Bima Yojana been implemented in J&K, treatment expenditures of both Ramzan and Baba, and hundreds of others facing same fate, would have been covered.
The scheme was rolled out in 2008 and was operationalised in 20 states to mitigate the financial problems arising out of catastrophic health episodes. J&K is the one of the very few states in India where this scheme was relegated to papers only for about a decade.
In the previous budget, GoI announced a new health insurance initiative ‘National Health Protection Scheme’. Twenty states, including J&K have signed a memorandum with union health ministry to implement the scheme on 90:10 funding pattern.
“In J&K, this insurance scheme, based on ‘deprivation criteria’ is planned to be extended to 30 lakh individuals or 6.13 lakh families,” state nodal officer for NHPM, Dr Sumir Mattoo said.
Dr Matoo said, “The under-privileged families would be entitled to a benefit of up to Rs 5 lakh a year under the scheme.” The scheme would be rolled out on 15 August.
The cashless and paperless scheme will have empanelled hospitals in the state and across India, and the patient will have flexibility to choose the hospital.