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Hospitals compromise health insurance scheme

Gururaj Jamkhandi  |  Chennai/ Dharwad 

The Karnataka government’s ‘Yashaswini’, a health insurance scheme for rural co-operative society members now stands compromised, thanks to the hospitals in many parts of the state insisting on patients paying up before being discharge. But, the scheme envisages free medical benefit under any of the 1,600 diseases and surgeries listed.

The hospitals treating the card holders have to send details of the treatment to the Trust for scrutiny online. However, many hospitals in north Karnataka districts are forcing the card holders to pay up the full amount and take the refund as and when it comes from the Trust. This has put the poor farmers, particularly those undergoing costly surgeries in a spot.

The scheme has a network of private hospitals besides government hospitals where the card holders can take the treatment without payment.

Said a card holder of Aminabhavi who was made to pay up the full amount at a nursing home in Dharwad for his son’s treatment. “The hospital management asked me to make the full payment and take the refund as and when it comes. They are not ready to accept the provisions of the scheme.”

Enquiries revealed private hospitals offering treatment under the scheme have to wait for months together to receive reimbursements. According to official sources, the hospitals in Dharwad district are yet to receive over Rs 1 crore for treating patients. Sources in private hospitals said there has been undue delays in uploading the names of beneficiaries online.

“When the card holders come to us we do not find their names in the list online. We send them back. Moreover, there is inordinate delay in scrutinising the treatment details and passing the bills for payment. We have no option but to collect the amount from the patients and ask them to come for refund later.”

The farmers also alleged that they have to bribe the officials at the local cooperative society to get the documents confirming their membership. “The procedure is cumbersome and we are exploited. Nobody gives correct details about the scheme to the illiterate farmers,” Desai complained.

Dharwad district has just 3,840 members under the scheme this year till date. There are 15 hospitals in the network of which 13 are private nursing homes.

First Published: Tue, May 31 2011. 00:11 IST