supernova_68

supernova_68 t1_jdtc62r wrote

At rates lower than cost of doing business for many hospitals thats why many small hospitals in villages had already refused to participate in an already working state sponsored health insurance scheme, because the cost of doing business in their area was higher than what the govt. Was offering.

Its like mandating you to work at rate lower than minimum wage.

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supernova_68 t1_jdtbava wrote

Problem is govt. Itself decides the package rate for all ailments ( which is quite low) and won't pay a dime extra (they even cut TDS form the decided package rate). So if an emergency patient requires a costly medication or much longer duration of stay, its upto hospital to decide whether to take the lose and provide the service or face the inevitable fine.

Also package rate is same for all hospitals, even if one is running in a village or a capital city. Running cost of both is vastly different. For eg : a super speciality doctor might agree to visit in jaipur hospital for fraction of price than to a village 100km away from jaipur.

>Btw state govt. Of Rajasthan provides free health insurance to all families in Rajasthan worth 25lakh rupees (30k$) per family.

No it doesn't, it uses ayushman bharat as base for covering low income group, then citizen have to pay Rs 850/ family / year to include in the scheme. Also package rates are way lower in chiranjeevi yojna than national Ayushman Bharat yojna.

Also govt doesn't provide payment for almost 4-6 months for every approved case, and the appointed insurance company regularly reject cases on basis of clerical mistake, or demand investigation which are not even in minimum document list. These cases get overturned if you pay to fight it at highest level , even after that govt. Can take more than 1 year for the payment. Many hospitals have not received payment for case overturned in 2018.

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