29/08/2024
| OPINION
The Government of Sikkim, under the leadership of Chief Minister Prem Singh Tamang (Golay), has long been recognized for its commitment to providing financial aid to Sikkimay in need of expensive and critical medical procedures. From organ transplants to open-heart surgeries and major interventions following road traffic accidents, the state has offered much-needed financial support. Chief Minister Golay's administration has shown remarkable generosity and dedication to the welfare of Sikkimay people, particularly in the healthcare sector. However, as commendable as these efforts are, the process of accessing this aid remains a significant challenge for patients and their families.
Under the current system, patients must obtain recommendations from an MLA, gather necessary documentation, and submit their applications to the Chief Minister's Medical Assistance Cell. While this process is well-intentioned, it can be an overwhelming burden for those already grappling with serious health issues. The need to visit various offices, collect endorsements, and wait for approvals adds unnecessary stress during a time when focus should be solely on recovery.
Moreover, delays in receiving financial support can sometimes hinder the timely medical intervention that is crucial for saving lives, and possible pilferage could be another area of concern.
The Potential of a Health Card System
To address these challenges, Sikkim could benefit from adopting a health card system as an alternative to the current model of direct financial aid. A health card system would allow patients to receive necessary medical treatment without upfront payments or the hurdles currently in place. Here’s how such a system could revolutionize healthcare in Sikkim:
1. Cashless Treatment:
Patients would no longer need to worry about paying out-of-pocket at the time of service. With a health card, treatment costs at designated hospitals would be covered directly by the government, significantly reducing the financial burden on families.
2. Nationwide Access to Healthcare:
Unlike the existing system, which often limits treatment options to hospitals in Siliguri or within the state, a health card could connect patients to a network of hospitals across India. This would provide greater flexibility in seeking the best possible care, whether in specialized facilities out of state or closer to home.
3. Convenience and Reduced Stress:
A health card would eliminate the need for patients and their families to navigate the cumbersome process of gathering recommendations, stamps, and documentation. Instead, patients would simply present their health card at the hospital, and the necessary approvals and payments would be handled seamlessly behind the scenes. This convenience is especially
important for those facing serious illnesses, where minimizing stress can significantly impact recovery.
4. Cost Efficiency for the Government:
By negotiating bulk deals with insurance companies or healthcare providers, the government could potentially lower the overall cost of medical care. Rather than disbursing large sums on a case-by-case basis, the government could pay a pre-negotiated rate for services covered under the health card system. This approach not only saves money but also ensures a more efficient use of public funds.
Learning from Other States: Indian Case Studies
The idea of a health card system is not entirely new to India. Several states have implemented similar models with considerable success, offering valuable lessons that Sikkim can learn from.
1. Aarogyasri Health Care Trust in Andhra Pradesh and Telangana:
One of the most successful examples of a state-run health card system is the Aarogyasri scheme in Andhra Pradesh, which was later adopted by Telangana. Under this program, families below the poverty line (BPL) are provided with Aarogyasri cards, which entitle them to cashless treatment for various medical conditions at empaneled hospitals. The scheme covers a wide range of treatments, including surgeries, critical care, and even cancer treatments. The success of Aarogyasri lies in its comprehensive coverage and the ease with which beneficiaries can access medical services without financial strain.
2. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY):
While not limited to a single state, the AB-PMJAY is a nationwide initiative that provides health coverage to economically vulnerable families.
It offers a cashless and paperless access model, where beneficiaries can use their health card at any empaneled hospital across the country. The program has been implemented successfully in states like Haryana and Maharashtra, where large segments of the population have benefitted from timely medical care without the burden of direct payments. The digital integration of this scheme ensures transparency and quick service delivery, elements that Sikkim could incorporate into its own health card system.
3. Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS):
Tamil Nadu has been at the forefront of implementing health insurance schemes that cater to its populace. The CMCHIS provides insurance coverage to millions of families, enabling them to receive treatment for a variety of ailments at no cost. The state government has successfully partnered with private insurers to manage and fund the scheme, ensuring broad access to quality healthcare. The CMCHIS is also notable for its efficient grievance redressal mechanism, which helps maintain trust and satisfaction among beneficiaries.
4. Mukhyamantri Amrutum (MA) Yojana in Gujarat:
Gujarat’s Mukhyamantri Amrutum Yojana is another example of a well-functioning health card system. Initially launched for BPL families, the scheme was later extended to lower middle-class families as well. The MA card allows beneficiaries to receive cashless treatment at empaneled hospitals, covering a wide array of medical services, including tertiary care procedures. The success of the MA Yojana is attributed to its strong network of hospitals and the government’s active role in monitoring and improving the scheme.
While the current financial aid program in Sikkim is a commendable effort by the government, led by the generous and forward-thinking Chief Minister Prem Singh Tamang (Golay), it is evident that there is room for improvement. By adopting a health card system, Sikkim can offer a more streamlined, cashless, and transparent alternative that ensures faster and more equitable access to healthcare. The success stories from Andhra Pradesh, Telangana, Tamil Nadu and Gujarat provide a roadmap for implementing such a system.
A health card system not only benefits patients by providing quicker and stress-free access to medical care but also allows the government to optimize resource allocation, ensuring better healthcare outcomes. By embracing such a forward-thinking approach, Sikkim can further strengthen its commitment to the health and well-being of our people, setting a new standard for healthcare delivery in our region. Chief Minister Golay's leadership in exploring and potentially implementing such innovative solutions reflects his ongoing dedication to the welfare of we The Sikkmay.
About the Writer:-
Rajen Subedi Chhetry is a Sikkimay from West Sikkim, Corporate Business Leader in Mumbai, Social Worker, ex-Entrepreneur, Ex-Founder President Gorkha Youth and Student’s Association of India (GYASA), Ex-Delhi Police Northeast Representative (DPNER) for Sikkim in Delhi.
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