Hospitals seek update in Ayushman Bharat packages

Many patients still incur catastrophic expenses on healthcare
Hospitals seek update in Ayushman Bharat packages
The Golden Card pooled only Rs 20,000 to her treatment package. Six months on, the family continues to repay the relatives from whom the money was borrowed for the emergency. [Representational Image] File/ GK

Srinagar: Treating doctors across hospitals of Kashmir have sought a review of the Ayushman Bharat health packages, expressing concern over the expenses that many poor patients continue to incur for treatment due exclusion of the specific implants and devices needed for their condition.

Asiya Amir (name changed), a 40 year old female from Baramulla district had a shoulder fracture for which she needed implants. Despite having a Golden Card and being treated in a Government Hospital, her surgery cost the impoverished family Rs 90,000.

The Golden Card pooled only Rs 20,000 to her treatment package. Six months on, the family continues to repay the relatives from whom the money was borrowed for the emergency.

“This defeats the purpose of the Ayushman Bharat Scheme. No doubt, it is helping thousands, but there still are patients who end up in huge debts because of a health emergency,” a senior doctor treating the patient said.

He said that there is a dire need of updating what is covered under the Ayushman Bharat scheme. “Logically, every implant must be provided free of cost to the patient, be it for orthopedics, surgical or others. However, the packages have been designed in a manner that leaves a number of items out,” he said.

At another tertiary care hospital, a patient admitted for Road Traffic Accident and head injury battled for life while his family tried to arrange Rs 50,000 for an artificial cranial implant.

The neurosurgery of this patient could not progress because the Golden Card and the specific packages for head injuries did not cover the costs of an implant.

“Sometimes, we are left frustrated because a slight variation from what is mentioned in the Ayushman Bharat packages can ruin the case of a patient. There sure needs to be an updated design of this scheme,” a surgeon at this hospital said.

Recently, a study from SKIMS Soura titled Functioning of Ayushman Bharat Scheme at SKIMS Srinagar found that manpower training was the “biggest hurdle” during the initiation of the scheme. The study also noted that there were impediments in conversion of schemes and patients admitted for medical conditions, requiring a surgical treatment afterwards and vice-versa, found it difficult to avail the benefits of Golden Card.

Many doctors that Greater Kashmir has spoken to urged that J&K Government revises the package rates, turn-around time and packages per se to smoothen the implementation of this Health Insurance Scheme being provided free of cost to lakhs in the UT.

“Government is spending a lot on this scheme, but the poor people must not continue to suffer due to some restrictions and clauses that can easily be addressed,” a senior administrator in a tertiary care hospital of Srinagar said.

The Health and Medical Education Department, when asked for a response, said the scheme was being updated from time-to-time. “We have experts on board that help in improving the design of this mega-project,” a top official in the department said.

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