Tuesday, August 11, 2009

Medical Insurance for Rs 5 a month (why India is incredible)

Dr Devi Prasad Shetty sat before then-Karnataka Chief Minister SM Krishna, now the foreign minister, and said the unimaginable — for an insurance premium of Rs 5 a month, he would take the best healthcare to the poorest.
Krishna’s aides in the room laughed, and one of them smirked: “Five rupees doesn’t even get you a packet of bidi.”
But it got the poor much more. And a health insurance project Dr Shetty began in 2002 in Karnataka has been adopted by the government and opened the doors of world-class healthcare to 3 million people there.
Now he wants to come to Delhi and promises to recreate the same health revolution with a hospital and an insurance plan.Dr Shetty’s model for Delhi involves dramatically lowering surgery costs and using the innovative tool of electricity bills to collect premium payments of Rs 10 to make sure residents of the city of 15 million can get world-class treatment accessible currently only to the rich.
Except: “Nobody wants us to come to Delhi,” says Dr Shetty, chairman of Narayan Hrudayalaya, one of the world’s busiest heart hospitals — and probably the least expensive.
He said the hospital had been in discussion with the government since 2005.
“Last four years I have been trying hard to get some piece of land or do something in Delhi. But nobody wants us… because the moment our group comes, the cost of all things will come down,” he told HT at the hospital complex in Bangalore, which hosts patients from 56 countries. He walked past a ward where just days-old children are brought after heart surgery.
The Delhi government has in the past helped private hospitals in the city with very cheap land and other concessions. It has so far provided land at subsidised rates to over 40 hospitals, which include big names like Apollo Hospital, Fortis Group of Hospital, Max Healthcare and VIMHANS, among others. This has been done on the condition that these hospitals provide 20 per cent of total OPD patients (people who don’t require hospitalisation) and 10 per cent of total IPD patients (those hospitalised and in need of surgery) free treatment every month.
However, 80 per cent of such hospitals haven’t fulfilled their part of the bargain. Recently, the Delhi government dragged Apollo to court for not providing free treatment, even after it was given land by the late prime minister Rajiv Gandhi for Re 1 only.
Delhi Health Minister Kiran Walia said she was unaware of any efforts by Narayana Hrudayalaya to make inroads into Delhi, and maybe the files were lost.
“Dr Shetty may have approached the Delhi government at the time of the previous minister (Dr Yoganand Shastri) but they have not come to me certainly,” she told HT. “I fear the files may have got misplaced or buried in the bureaucracy.”Walia has been minister for eight months.
Principal Health Secretary JP Singh, however, said he had received an application from Narayana Hrudayalaya for private participation in two Delhi government hospital projects coming up in Tahirpur and Janakpuri. But with the bidding still in process, it will have to wait.
Dr Shetty was awarded the Padma Shri, India’s leading civilian honour, in 2004. His model involves a clever mix of philanthropy and good business sense — which allows him to carry out surgeries for very low fees due to very large numbers, even while making a profit.
Philanthropy-plus-profits is a model that has been shown to work in India. Two of the country’s most profitable hospitals are Sir Ganga Ram Hospital in New Delhi and the Christian Medical College, Vellore, which aggressively reach out to poor patients.
Cheaper heart care is crucial for India, where people are genetically three times more vulnerable to cardiac problems than Europeans. The average age of cardiac patients is 45 years now. Approximately 2.2 lakh babies are born with heart ailments each year.
“Delhi is the ideal state where every citizen can have health insurance because the contribution can be just Rs 5 or Rs 10 per month,” Dr Shetty said.
“Every citizen should be made to pay. And how do you collect money from them? You collect the premium through the electricity bill.”
Apart from heart hospitals, Dr Shetty plans to set up cancer hospitals in 50 cities and towns over the next few years.“We feel we can reduce the cost of cancer care by 75 per cent… compared to existing Indian costs,” he said.
Courtesy: HindustanTimes


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