Kolkata: After a whispering campaign that lasted a few days, Bharatiya Janata Party has formally levelled a new allegation: the Mamata Banerjee government’s universal health insurance coverage scheme is a hoax. The BJP’s West Bengal unit president Dilip Ghosh made the allegation on Thursday with a Facebook post.
Swasthya Sathi, the health insurance scheme that the state’s ruling party, the Trinamool Congress (TMC) considers its trump card, was recently extended to the state’s entire population, only keeping out those already enjoying government-funded health insurance benefits.
In the course of the Duare Sarkar, or ‘government at your door’ campaign, more than half of the attendees at various events enrolled themselves for the Swasthya Sathi scheme, indicating its popularity. The scheme offers cashless insurance coverage of up to Rs 5 lakh per year per family, is issued in the name of a woman in the family, and if the woman is married she can add her parents as part of the family.
The BJP, which has so long been attacking the Mamata Banerjee government for not implementing Prime Minister Narendra Modi’s Ayushman Bharat health insurance scheme in the state, has not been able to continue with the line since Swasthya Sathi was announced.
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After calling the chief minister’s pet scheme a hoax, Dilip Ghosh on Thursday said: “If out of the state’s 10 crore population even 5% seeks its benefits, it would cost the state’s exchequer of Rs 50,000 crore a year. But this year the state’s health budget is altogether Rs 12,000 crore. Where will money for Swasthya Sathi come from?”
The BJP arrived at a figure of Rs 1 lakh as expenditure on average per year for every person taking the benefits of the scheme.
Senior BJP leaders have said the same in public rallies as well, trying to convince people that the Mamata Banerjee government is trying to fool voters ahead of the assembly elections due in another four months.
‘Exaggerated rate’
State health secretary Narayan Swarup Nigam said that the government has not engaged any insurance company and therefore does not need to pay any premium upfront.
“First of all, 5% of the state’s population getting hospitalised is a highly exaggerated rate. Never do so many people get hospitalised at once. It may at most be around 1% of the population. And second, the national average for per person expenditure in hospitals is around Rs 15,000-Rs 20,000. So, it’s very much manageable and within our budget allocation,” Nigam said.
About 1% of the state’s estimated population claiming Rs 20,000 per year on an average should cost the state Rs 2,000 crore.
“We had engaged the Indian Statistical Institute for studying possible expenditure and it is based on their study that we have made all our arrangements and estimations,” he added.
The TMC’s Rajya Sabha leader and national spokesperson Derek O’Brien said that the state budget for Swasthya Sathi, which was introduced in 2016, had been Rs 925 crore per year. With the new inclusions, for 2021, it will be Rs 2,000 crore.
“Ayushman Bharat covers only 40% of India’s population and it’s funded partly (60%) by the Centre and the rest of the expenses (40%) are borne by the state. Swasthya Sathi is fully funded by the state government and covers the entire population,” O’Brien said.
The enlisted health institutions include about 1,500 in the state and some prominent ones outside it.
The Ayushman Bharat example
Chandrima Bhattacharya, deputy minister of health, said that journalists should first ask BJP leaders and Union ministers how Ayushman Bharat works. “The opposition, especially the BJP, are spreading misinformation because the Bengal government’s scheme is earning praise from one and all,” she said.
The Centre had allocated Rs 6,556 for Ayushman Bharat (budget estimate) in the budget for 2019-20 but on February 1, 2020 finance minister Nirmala Sitharaman revised the budget at Rs 3,314 crore (revised estimate).
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Given that it covers 40% of India’s estimated population of 138 crore in 2020, the estimated beneficiary scale is around 55 crore. Going by Bengal BJP’s argument, if even 5% of those entitled (2.75 crore) seek Rs 1 lakh benefit per year, the Centre should have had to pay Rs 2,75,000 crore per year.
On December 10, the TMC claimed that 1.4 crore families had been brought under the coverage of this group insurance scheme, 13.2 lakh people received their treatments, and the government has yet spent Rs 1,291 crore.
On December 15, the state government claimed 60% of the state’s population had enrolled for the scheme, a good number of them during the ‘Duare Sarkar’ campaign.
Treatment in West Bengal’s government hospitals are free.
Private hospitals
However, private hospitals recently urged the state government to review the rates for treatment under this scheme, arguing that the actual cost of treatment was higher. They also urged the government to release payments as early as possible, as the delay on the government’s end was affecting the hospitals’ financial health.
The state government, while agreeing to consider their proposal, asked the hospital authorities to ensure that no one holding a scheme card was refused admission. Recently, there had been several allegations that private hospitals were adopting to various ploys to refuse admission to people holding Swasthya Sathi cards.
On the political front, while the TMC has been highlighting cases of patients receiving the card while on hospital beds or in ambulances and them availing themselves of the free treatment, the BJP has highlighted a few cases of people being refused admission by private hospitals.
“We investigated the alleged cases of refusal. In some cases, the refusal was due to an inadvertent mistake by the cardholder. Some people, who already had their names enrolled, had re-enrolled their names during the recent ‘Duare Sarkar’ camps. Thus, the new cards they received got marked as duplicates. When they produced this new card in hospitals, the authorities asked for the original one,” said a senior health department official who did not want to be named.
Over the past one week, the state government has started awareness campaigns asking people not to enrol afresh if they have already enrolled.
Snigdhendu Bhattacharya is a journalist and author based in Kolkata.