Abandoning not an option; Medisep should be maintained with timely modifications

Doubts were raised from many quarters whether 'Medisep', the health insurance scheme for government employees and pensioners, will die prematurely as a scheme that no one wants. As the term of the current Medicep scheme is set to end in June this year, Finance Minister Balagopal had convened a meeting of the leaders of the employees' unions the other day to discuss the issue. Though there were many complaints, not many were in favour of abandoning the project. A majority of the service organisations have demanded that the project be continued. There was a general opinion that there should be a timely revision of the project after including acceptable suggestions. Since the finance minister has made it clear that the government cannot take up the project, reform is the only appropriate option. Steps should be initiated to implement the new scheme with the necessary changes as soon as the term of the present scheme expires.

More than five lakh employees and seven lakh pensioners in the state are covered under the Medisep scheme. Beneficiaries are paying a share of Rs 500 per month for Medisep. The insurance company which took over the management of the scheme say that this share is not enough to pay the claim of the employees. They are of the view that they cannot move forward without increasing the premium amount. However, the organisations claim that not even one-fourth of the employees and pensioners who give their share come forward to take the benefit. Moreover, many of the leading hospitals are not yet ready to participate in the project. A family will get six lakh rupees for treatment for three years. At a time when the cost of treatment and medicines for many diseases is skyrocketing, it cannot be said that the benefit of six lakh rupees for three years is too high.

The government can put pressure on leading hospitals that are away from the panel to bring them to Medisep. It is the delay in receiving the money that has prompted large private hospitals to turn a blind eye to Medisep. At a meeting convened by the Finance Minister, the representatives of the organisations had demanded that steps should be taken to make available insurance amounts in advance for deadly diseases and certain types of diseases that require treatment and care on a regular basis. This can be checked out. The condition that the benefit can be availed only if there is at least one day of hospitalisation should also be reconsidered. The demand to provide insurance benefits for OP treatment, for patients who require frequent hospital visits, is justified.

A decision on the demand to increase Medisep's premium can be taken in consultation with insurance companies. There is nothing wrong with asking for an increase in insurance premiums at a time when prices of everything are going up. This is because there has been an increase in the monthly income of employees and pensioners as well. The curse of such social security schemes is the procedural hurdles and unbearable delays. Although the terms and conditions have been prepared in advance, there is a tendency for the interests of the beneficiary to be hurt when things come to practice. This approach has to be changed. There should not be a situation where this exemplary project is abandoned for any reason.