Panaji: Manohar Parrikar-led government seems to have erred financially while implementing its flagship medical insurance scheme – Deen Dayal Seva Yojana (DDSY) – with the state coffers being stressed to the tune of Rs 38 Crore.
A close analysis of this scheme, which is a brainchild of Health Minister Vishwajit Rane, indicates that the difference between money reimbursed through various claims is much lower than the premium paid to the company.
Moreover, the State has done financial jugglery by paying to the insurance firm for charging people in Goa Medical College and Hospital and its other hospitals.
These hospitals have been traditionally offering free medical treatment.
As per the documents provided by State Health department, government has paid Rs 120.49 crore to United India Insurance Company from September 2016, when the scheme was kicked off, till May, 2018 when it actually was taken over by the State government for implementation on its own.
From September 1, 2016 till August 31, 2017, State has paid Rs 64.52 crore to the company while Rs 55.97 crore was paid from September 2017 to May 2018.
But during the entire tenure, the actual insurance claims after conducting various medical procedures by beneficiaries was Rs 113.04 crore, which included Rs 33.71 crore for the patients treated at GMCH and other government run hospitals.
In addition, the insurance company is yet to pay Rs 2.80 crore as a reimbursement towards various claims.
The money reimbursed by the Insurance Company to GMCH and other government institution may not be calculated as government pays for the premium and same government claims it in the form of reimbursement.
This means, the actual reimbursement which can be calculated is only to the private hospitals which is to the tune of Rs 60.63 crore within the state and Rs 18.70 crore for those empanelled outside the State.
So considering Rs 33.71 crore paid to government-run institutions and difference of Rs five crores (insurance company was paid Rs 120 crore and reimbursed back Rs 113 crore and Rs 2 crore pending), the total loss to the state is to the tune of Rs 38 crore.
The loss which has been incurred is currently being saved as State government has taken over the scheme for the implementation on its own. Goa government has began implementing the medical scheme on its own, while rebidding has been in the process.
The experts claim that it would be wise if State government runs the scheme on its own rather than allowing the Insurance Companies mint the money. The services in the State run hospitals can continue being free of cost, while the patients can swipe the card for record sake.
There are also suggestions that the State government should not minus money from the card for treatment in the government run hospitals so that the patients can avail the entire benefit of Rs 2.5 lakh annually in the private run institutions.
