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Modern medicine, with its advancement in technology has made
rapid strides in diagnosis and treatment of many a complicated disease,
hitherto unattended thus reducing the morbidity and mortality enormously and
improving quality of life. While advent of non-invasive diagnostic tools like
CT Scan, MRI, Ultra Sound and radio isotope studies made diagnosis of disease
more specific, the latest gadgets such as video endoscopes, laproscope etc.
made treatment and surgical procedures less cumbersome and simple.
Hence there is a felt need in the State to provide medical assistance to
families living below poverty line for the treatment of serious ailments such
as cancer, kidney failure, heart and neurosurgical diseases etc., requiring
hospitalization and surgery. Available network of government hospitals do not
have the requisite equipment or the facility or the specialist pool of doctors
to meet the state wide requirement for the treatment of such diseases. Large
proportions of people, especially below poverty line borrow money or sell
assets to pay for hospitalization. Presently many people suffering from such
diseases are approaching the Government to provide financial assistance to meet
hospitalization expenses for surgical procedures.During the period from
14.05.2004 to 26.06.2007, financial assistance to a tune of Rs. 168.52crores
has been provided from CM's Relief Fund in 55361 cases to meet hospitalization
expenses for such people. From the experience gained, it is now felt that the
assistance could be institutionalized so that its benefit can be accessed by
poor people across the State easily and in a trouble free manner. Health
Insurance could be a way of removing the financial barriers and improving
access of poor to quality medical care; of providing financial protection
against high medical expenses; and negotiating with the providers for better
quality care.
In order to operate the scheme professionally in a cost
effective manner, public private partnership will be promoted between the
Insurance Company / TPA, the private sector hospitals and the State agencies.
"Aarogyasri Health Care Trust" recently setup by the State Government for the
implementation of the Scheme will assist the insurance company / TPA /
Beneficiaries and coordinate with Medical and Health Deptt., District
Collectors, Civil Supplies Department etc.
THE SCHEME
Name:
RAJIV AAROGYASRI COMMUNITY HEALTH INSURANCE SCHEME
Objective:
To improve access of BPL families to quality medical care for treatment of
diseases involving hospitalization and surgery through an identified network of
health care providers. In the initial phase, the scheme would provide coverage
for the following system.
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