Ensuring health in Tamil Nadu
With the launch of the Comprehensive Health Insurance Scheme (CHIS) in January for families with annual income less than R72,000, the Tamil Nadu government is trying to step up efforts to provide medical cover to its poor. A majority of the state’s 801 hospitals empanelled in 32 districts are government-owned and the treatment cost reimbursed towards in-patient treatment is to be divided in the ratio 15:85 between the hospital staff and the hospital infrastructure development corpus.
As per the CHIS scheme, the sum assured for each family would be R1 lakh every year for a total period of four years amounting to a total cover of R4 lakh. The sum insured for certain treatments of a critical nature could be enhanced to R1.5 lakh. The scheme operates on a floater basis (insuring the entire family) and covers 1,056 diseases, 1,016 procedures, 113 follow-up procedures and 23 diagnostic procedures. There is no restriction on the number of times a benefit is availed. The unutilised entitlement will lapse at the end of every policy year. The total number of benefitting families, as per the cashless hospitalisation scheme, has been identified at around 1.34 crore, of which, 1.07 crore families have already received insurance cards.
“Claims to the tune of R279 crore have been disbursed to the hospitals and (these) are utilising the funds to improve their infrastructure and overall maintenance,” says Dr J Radhakrishnan, health secretary, government of Tamil Nadu. "In the course of implementation, we found that some of the districts needed more awareness in availing the scheme and, out of 32 districts, we have identified six, like Ariyalur, Virudhunagar and Cuddalore, to launch a vigorous awareness campaign to mobilise the beneficiaries.”
Since the launch of the CHIS, Madras Medical College (MMC) and eight other affiliated hospitals have so far treated close to 14,000 patients, says Dr V Kanagasabai, dean, MMC. “Out of the R14-crore reimbursement, around R9 crore has been spent towards buying equipment and developing infrastructure... Apportioning 15% of the CHIS income as staff reward further boosts the service sentiment of the staff when extending care to the under-privileged sections,” he adds.
The CHIS was officially launched by the chief minister by handing out a cheque of R183.64 crore towards the initial premium payment to the PSU insurer United India Insurance. A total annual premium sum of R750 crore has been earmarked for the CHIS.
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