48 lakh Smart Card prepared for B.P.L. families under National Health Insurance Scheme

For the health sector in Uttar Pradesh, the last few years have been mired in controversies and graft during the previous BSP government where a multi crore scam in the National Rural Health Mission (NRHM) caught national headlines. Last week when the state was awarded the ‘Most Improved State’ award by the union government, not only was the infamous past washed away but a new beginning was ushered in.
With Smart Cards made for 48 lakh families under the National Health Insurance Scheme, many feel this was a 360 degree turnaround in the health sector of Uttar Pradesh. Officials say, the success run was largely reached due to the leadership of the Chief Minister Mr. Akhilesh Yadav and the clear cut message of deliverance given from the State’s Health Minister Mr. Ahmad Hasan.
The reward is a huge recognition to the efforts of thousands of workers in the state government who let this milestone happen. Under the scheme, the UPRIMSR in Saifai, Etawah has been rewarded for its good and laudable work as an independent hospital. Compared to the first phase of the scheme, more than 25% of the below poverty line (BPL) population has been assimilated and smart cards for 48, 65,692 families have been made.
As part of course correction, taken as part of the inferences drawn from the first phase of the scheme where the claims were not attended to by listed hospitals due to tardy payment schedules, for the first time the anomalies were weeded out by the help of technique and weekly reviews and a server was established at the state level. The intervention and initiative saw miraculous results and of the claims made by listed hospitals, as many as 74% were settled within 30 days.
To ensure and enhance transparency in listing of hospitals, a district insurance committee was formed under the chairmanship of the district magistrate at district levels. This committee comprised of the district magistrate, the chief medical officer/DKMA and the representatives of the selected insurance company and after due deliberations, the recommendations to list hospitals was sent for approval to SACHI.
Owing to the prompt process and quick decision making, 1486 hospitals have been listed so far, of which 823 are private hospitals while 663 are government hospitals. Aware of road blocks for the first time a two tier complaint redressal system was set rolling in which claimants dissatisfied with decisions could appeal to district and then to the state level committee.
The scheme, kick started to benefit the BPL families, as per the 2002 census provides a smart card at a basic fee of Rs 30 which is used to meet all administrative expenses incurred in the scheme. The field key officer (FKO) is named for the completion of the nomination process in which a family, with considered unit of five, is listed on the smart card. The hitherto used 32 kb card has been replaced by a 64 kb card so that the beneficiaries can avail the benefits of both the state and central schemes.
To smart card holding families a sum of Rs 30,000 is entitled on floater basis for one year and a total of 1090 pre decided diseases/packages is available through indoor patient facilities. The scheme also entails giving of food and Rs 100 per day for transport on discharge from hospital but a maximum of Rs 1,000 in a year. 75% of the annual premium on the scheme is borne by the central government and the remaining 25% by the state government.
The cost of a smart card (Rs 60) is separately borne by the union government. Till March 31, 2013 48 lakh smart cards have been made in Uttar Pradesh and nomination process is underway in 21 districts, by the end of which 58 lakh beneficiary families are likely to be assimilated in the scheme. The scheme is an added benefit for residents of the state who are already availing the 108 ambulance service for emergency services.
The scheme, officials point out has achieved the state where it is in at present largely due to establishing of state level servers, appointment of technical assistants at districts, establishment of DKMA mobile servers (laptops) at district level. The scheme has also been expedited due to the involvement of trained workforce through the Aanganwadi’s. A free call centre at the state level (SACHI) at the state level has also been established and a toll free number 1800 1800 4444 has been created and a helpline 9198004444 also made.

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