Before Centre's Announcement, Tamil Nadu Had Own Health Insurance Scheme

At Vallipuram, a small village in Tamil Nadu's Kancheepuram district, two-year old Varun's parents were shattered last year when doctors told them about a hole in the child's heart.

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Before Centre's Announcement, Tamil Nadu Had Own Health Insurance Scheme

S Lakhsmipathy, a farmer, used the insurance cover for undergoing a surgery.


Chennai:  As the Modi government has recently announced an ambitious Rs 5 lakh medical insurance cover for 10 crore poor families in Budget 2018, the centre can probably take a few lessons from Tamil Nadu which launched its own health insurance programme in 2009 to help the needy in the state. 

At Vallipuram, a small village in Tamil Nadu's Kancheepuram district, two-year old Varun's parents were shattered last year when doctors told them about a hole in the child's heart. 

Varun's father, a construction labourer, could not have afforded an open heart surgery that would have cost him more than Rs 1 lakh. 

It was the state government's free health insurance scheme that helped the family. The two-year-old underwent a heart surgery at Chennai's Apollo hospitals. 

Now in kindergarten, Varun is healthy and happy. His mother S Keerthika says, "The surgery was carried out well in time, and we were able to save our child. Without this scheme, it would have taken us long to arrange the money." 

Sixty-year-old S Lakhsmipathy, a farmer, also used the government scheme for the surgical removal of a gland that had developed on his throat. After facing crop losses for several years due to drought, he says it was impossible for him to afford the surgery. 

"The scheme has helped others like me. And I've a suggestion to improve it also. People from remote villages have to travel a lot to reach hospitals. We don't have proper transport system. So like 108 ambulances, if mobile clinics could come here at least once a week for medical checkup, it would be really helpful." 

Former Chief Minister M Karunanidhi, who launched the health scheme with Rs 1 lakh cover in 2009, publicised it with an aggressive ad campaign and an active participation by district administrations. About 1.57 crore families enrolled for the scheme. 829 hospitals were empanelled. It pays an annual premium of Rs 1,348 crore at Rs 699 per family.

Families are eligible for Rs 35.5 lakh cover for organ transplant or major surgeries. The only condition -- beneficiaries must earn Rs 72,000 a year or less. The specially abled people have no such restrictions. 

The cover includes 38 diagnostic procedures and nine high-end procedures including renal, heart, lung and liver transplants. 

The state also aims to set up one government medical college hospital in every district. With a network of 129 government and government medical college hospitals in the state, district authorities say these hospitals are able to recover 40 per cent of the premium paid by the government in the form of payments by insurance companies. This fund, they say, is used to expand hospitals and to enhance infrastructure. 

However, many want the government to relax eligibility norms.

P Ramu a shop owner, says, "I earn around Rs 10,000 a month but I'm not eligible for insurance. Healthcare is so expensive and the cost of living is so high, isn't it unfair to deny me insurance? My annual income is Rs 1,20,000, how I'd be able to afford a surgery say that would cost me more than a lakh? Should I lie about my income? Hope the central government scheme takes care of people like me."


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