There is indeed a noble intent behind the government's recently announced The National Health Protection Scheme ( NHPS), but it is most unlikely to benefit the common man in the country. In fact, it could even be misused if other necessary measures are not taken simultaneously.
In the past, such schemes have been abused by the unscrupulous elements who have already commercialized the medical profession. I feel that the scheme, despite its noble intentions, may end up benefitting the big corporate hospitals only, while the common man for whom it is intended, will be left high and dry.
What is required is the effective and rigorous control over the treatment cost --be it medicines, equipment, implants, hospital stay, diagnostics, etc.
Last year the government of India capped the prices of the stents, which should have reduced the cost of the angioplasty dramatically. But did the actual benefit reach the patients?
The answer is a big no.
Because, the unscrupulous elements in the medical profession, particularly those running the big corporate entities, have raised the costs of other things and eventually patients have to pay almost the same amount as before the stents prices were capped.
The medical insurance scheme is likely to meet a similar fate. The corporate hospitals, which are already empanelled with the government, may misuse the scheme by increasing the overall cost of the treatment.
Generally, 5 lakh rupees can adequately cover the treatment cost for most of the serious health problems such as heart or brain surgery. However, it will not hold true for the corporate hospitals which are notorious for charging exorbitant fee and dues from the patients.
Under these circumstances we need effective regulation on the cost of the treatment. First and foremost, we need to control the prices of medicines, which are the basic requirement for any treatment.
There is a massive difference in the actual manufacturing cost of the medicines and the prices at which these are sold to the patients. In fact, different companies manufacturing the same medicines may sell them at a huge price difference.
People feel that costlier drugs are more effective, but it is not true. When people have insurance cover, they don't even realise the cost difference. In such cases, the loss will be that of the government.
But at the same time, still a large number of medical practitioners believe in ethical practice. Now that the medical insurance scheme has been announced, the government must couple it with strict price regulation of the treatment costs. This will strengthen the scheme and help in providing complete and better treatment to the patients within the stipulated amount.
-Dr G S Grewal, former president Punjab Medical Council, is a member Core Committee ADEH