Twenty-year-old Prasanna, a farmer from Tumkur district of Karnataka, would have normally wasted away after he was stricken with a heart disease. However, a model health insurance scheme has provided a ray of hope to thousands like him, besides setting a splendid example of government-private partnership.
Prasanna underwent an open heart surgery for Rs 60 ($1.25), the annual premium for the Yeshasvini health scheme launched in the cooperative sector in 2003. This quiet health revolution reaching out to the have-nots has resulted in medical treatment to more than 85,000 farmers in the last two years. As many as 25,000 farmers have undergone various kinds of operations, including those of the heart, brain, stomach, eyes and the gall bladder, during this period.
Starting from the 800-bedded super-speciality Narayana Hrudalaya Hospital on the outskirts of Bangalore, it now reaches out to farmers through 170 hospitals across the state.
The scheme came into being ironically at a function where its originator — the Hrudalaya hospital founder and heart surgeon, Dr Devi Shetty — was invited to endorse a milk product. Dr Shetty, a foreign trained cardiologist who went on to become Mother Teresa's personal cardiac surgeon and then an unabashed advocate for providing modern health care to the poor, asked his hosts the Karnataka Milk Federation (KMF) to support a path-breaking idea. What he had to offer to the KMC's Managing Director was this: "I will extend health benefits to all your two million employees for just Rs 5 a month"
Fortunately, for the farmers and Karnataka, the then Chief Minister S M Krishna was also at the function. When this scheme was suggested to him by the KMF Managing Director, he asked his government to fine-tune it. So was born the Yeshasvini (meaning Victor) health programme with KMF members as its first beneficiaries. The scheme was extended to other cooperatives and now covers around 17 lakh farmers in the state.
The government jacked up the premium to Rs 7.50 a month for each member by contributing the extra Rs 2.50 from its own coffers. The manner in which the Yeshasvini scheme took off is also unique. The insurance fee was collected upfront for a year so that initial needs for funds could be minimised. The state government, on its part, made its infrastructure of post offices available to collect the Rs 5 premium, and issue a "Yeshasvini member card".
The initial task of getting hospitals to participate and selling the idea to the cooperatives was conducted by the Trust, but the daily operations were later handled by a third party, which also coordinated payments to hospitals.
Speaking about the scheme, Dr Shetty says out of the 85,000 who had received treatment under the scheme in the last two years, 25,000 had been operated upon. Besides recognising 170 hospitals, the Yeshasvini Trust also recognises four heart hospitals in the state for heart operations.
The scheme covers nearly 1,700 different types of operations which include operations of the stomach, gall bladder, eyes, brain and uterus. The members also get free outpatient consultation in all Yeshasvini recognised hospitals, besides getting discounts on outpatient investigations.
Dr Shetty says the scheme can be easily replicated elsewhere with the Maharashtra and Tamil Nadu governments in dialogue with the Trust to include cooperatives in their states in this programme.
"All it needs is 10 lakh members who have come together for some other reason other than healthcare like a cooperative society or a grameen bank. A monthly premium of Rs 10 to Rs 15 should be collected for the whole year and deposited in the account of the charitable trust responsible for implementation of the scheme. Lastly, recognised hospitals should offer comprehensive packages for the operation so that patients are not charged extra in case of complications".
Dr Shetty says Narayana Hrudalaya is ready to carry out the entire process of launching the scheme free of cost using its expertise and infrastructure in case any state government or organisation desires so. Trained at the Guy's College in Britain, Dr Shetty left a promising career to come back to Calcutta to work on pioneering low-cost heart surgery.
This led to the establishment of the Rabindranath Tagore International Institute of Cardiac Sciences in Kolkata in the nineties and the foundation of Narayana Hrudalaya in 2000 in Bangalore. He has not stopped at building world-class institutions which are aimed at providing quality health care to the underprivileged. He has instituted telemedicine to provide cardiac care free of cost to the poor by roping in ISRO.
Narayana Hrudalaya is also in the process of being declared a deemed university for postgraduate medical degrees and is on the road to becoming a health city, the dream goal of Dr Shetty.
How did he go about it?
"I realised that the bulk of the money of hospitals is earned from heart treatment and that needed to be reduced. We at Narayana Hrudalaya have done just that. We have gone in for large-scale operations and are currently performing 23 surgeries everyday. In Calcutta we are performing around eight surgeries everyday. This has reduced costs to Rs 65,000 for a bypass surgery", he said.
Prasanna underwent an open heart surgery for Rs 60 ($1.25), the annual premium for the Yeshasvini health scheme launched in the cooperative sector in 2003. This quiet health revolution reaching out to the have-nots has resulted in medical treatment to more than 85,000 farmers in the last two years. As many as 25,000 farmers have undergone various kinds of operations, including those of the heart, brain, stomach, eyes and the gall bladder, during this period.
Starting from the 800-bedded super-speciality Narayana Hrudalaya Hospital on the outskirts of Bangalore, it now reaches out to farmers through 170 hospitals across the state.
The scheme came into being ironically at a function where its originator — the Hrudalaya hospital founder and heart surgeon, Dr Devi Shetty — was invited to endorse a milk product. Dr Shetty, a foreign trained cardiologist who went on to become Mother Teresa's personal cardiac surgeon and then an unabashed advocate for providing modern health care to the poor, asked his hosts the Karnataka Milk Federation (KMF) to support a path-breaking idea. What he had to offer to the KMC's Managing Director was this: "I will extend health benefits to all your two million employees for just Rs 5 a month"
Fortunately, for the farmers and Karnataka, the then Chief Minister S M Krishna was also at the function. When this scheme was suggested to him by the KMF Managing Director, he asked his government to fine-tune it. So was born the Yeshasvini (meaning Victor) health programme with KMF members as its first beneficiaries. The scheme was extended to other cooperatives and now covers around 17 lakh farmers in the state.
The government jacked up the premium to Rs 7.50 a month for each member by contributing the extra Rs 2.50 from its own coffers. The manner in which the Yeshasvini scheme took off is also unique. The insurance fee was collected upfront for a year so that initial needs for funds could be minimised. The state government, on its part, made its infrastructure of post offices available to collect the Rs 5 premium, and issue a "Yeshasvini member card".
The initial task of getting hospitals to participate and selling the idea to the cooperatives was conducted by the Trust, but the daily operations were later handled by a third party, which also coordinated payments to hospitals.
Speaking about the scheme, Dr Shetty says out of the 85,000 who had received treatment under the scheme in the last two years, 25,000 had been operated upon. Besides recognising 170 hospitals, the Yeshasvini Trust also recognises four heart hospitals in the state for heart operations.
The scheme covers nearly 1,700 different types of operations which include operations of the stomach, gall bladder, eyes, brain and uterus. The members also get free outpatient consultation in all Yeshasvini recognised hospitals, besides getting discounts on outpatient investigations.
Dr Shetty says the scheme can be easily replicated elsewhere with the Maharashtra and Tamil Nadu governments in dialogue with the Trust to include cooperatives in their states in this programme.
"All it needs is 10 lakh members who have come together for some other reason other than healthcare like a cooperative society or a grameen bank. A monthly premium of Rs 10 to Rs 15 should be collected for the whole year and deposited in the account of the charitable trust responsible for implementation of the scheme. Lastly, recognised hospitals should offer comprehensive packages for the operation so that patients are not charged extra in case of complications".
Dr Shetty says Narayana Hrudalaya is ready to carry out the entire process of launching the scheme free of cost using its expertise and infrastructure in case any state government or organisation desires so. Trained at the Guy's College in Britain, Dr Shetty left a promising career to come back to Calcutta to work on pioneering low-cost heart surgery.
This led to the establishment of the Rabindranath Tagore International Institute of Cardiac Sciences in Kolkata in the nineties and the foundation of Narayana Hrudalaya in 2000 in Bangalore. He has not stopped at building world-class institutions which are aimed at providing quality health care to the underprivileged. He has instituted telemedicine to provide cardiac care free of cost to the poor by roping in ISRO.
Narayana Hrudalaya is also in the process of being declared a deemed university for postgraduate medical degrees and is on the road to becoming a health city, the dream goal of Dr Shetty.
How did he go about it?
"I realised that the bulk of the money of hospitals is earned from heart treatment and that needed to be reduced. We at Narayana Hrudalaya have done just that. We have gone in for large-scale operations and are currently performing 23 surgeries everyday. In Calcutta we are performing around eight surgeries everyday. This has reduced costs to Rs 65,000 for a bypass surgery", he said.
by Jangveer Singh
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