Following reluctance from major private hospitals to take part in the Rajiv Gandhi Jeevandayi Yojana over issues of bed reservations and low fixed rates for procedures, the state government has decided to seek legal opinion on the same.
Under the ambitious state health insurance scheme, over 20 million poor who will be allotted identity cards will be able to walk into any public or private empanelled hospital to get treatment for 972 surgical procedures with free medical treatment up to Rs1.5 lakh per annum.
The bone of contention for private charitable hospitals is if they sign up for the scheme, they will need to keep 10% of their beds reserved under the Bombay Public Trust Act (1950), adhere to costs set by the government for surgical procedures and keep 2% of their revenue aside for subsidising poor patients as called by the court, which they are unwilling to do.
“When we floated the scheme, we were expecting most private hospitals to participate. There will be more than 8000 beds made available through their participation. But now there seems to be some reluctance which we are trying to sort out,” said health minister Suresh Shetty, who had a meeting with Chief Minister Prithviraj Chavan on the issue.
According to senior health department officials, the private hospitals will come under the government’s direct scanner, which they want to avoid.
“The scheme will entail a government representative sitting in hospitals and making sure the poor benefit. The hospitals get heavy subsidies right from the land allotted to them by the government which they ought to respect,” the official said.
The private hospitals do not completely agree with the government. “ Firstly, this scheme is not compulsory and every hospital can take a call on whether it wants to enroll. But the larger issue is that the rates of surgeries that are prescribed by the government are way lower than what we charge our lowest class,” said Pramod Lele, CEO of Hinduja Hospital, who is also the president of Association of Hospitals (AOH) of Mumbai.
“We are following a court order that calls for keeping aside 2% of our turnover for catering to poor patients with an income of below Rs50,000 per annum,” said Lele. He added that AOH has asked the government to bring some clarity on following charitable laws.