Private hospitals demand revision of rates under Yeshasvini health scheme

BENGALURU: After the state government re-implemented the Yeshasvini Health Insurance Scheme, the Private Hospitals and Nursing Homes Association (PHANA) has expressed outrage against the ‘unscientific pricing’ for different procedures and has threatened to stop services under the scheme if the rates are not revised.

The Yeshasvini Health Insurance Scheme is widely used by farmers and people employed in the informal economy in Karnataka. The scheme was re-implemented on November 1. After it was brought back, the prices for different procedures have been reduced by 10 to 20 per cent compared to the prices fixed in 2017–2018. Under this scheme, 1,600 diseases can be treated.

The state government has re-implemented Yeshasvini Urban Cooperators Health Care Scheme.

The association has demanded that the government fix scientific prices as the health care sector is expensive and cannot be managed with minimum grants. Under this scheme, a beneficiary will get up to Rs 5 lakh health cover and the private hospital will spend Rs 40,000–50,000 while the government provides Rs 25,000. “If the government does not fulfil our demand, we will stop all the medical services under the scheme”, PHANA has warned.

What may happen if rates are not revised under the scheme?

Quality health care facilities will not be available to the poor and marginalised.

Hospitals may refuse to provide certain treatments and surgeries.

They may deliberately delay treatment due to the low price.

Possibility of demanding additional charges from patients in the form of treatment costs

If patients do not get proper treatment and hospitals demand additional fees, there is a possibility of people getting into confrontation with hospital staff.

Dr Prasanna, president of PHANA.

“The basic cost of the treatment was not fixed scientifically. Under the Yeshasvini Health Insurance Scheme, it is difficult to sustain in large numbers. This is a voluntary scheme, so private hospital may not implement it. There are no scientific calculations done. The cost of the treatment under the scheme should be increased. Private hospital can claim the amount of the treatment cost, but the money provided by the government is not sustainable. We will appeal to the government”, said Dr Prasanna, president of PHANA.