Modern medicine, with its advancement in technology has made rapid strides in diagnosis and treatment of many a complicated disease, hitherto unattended thus reducing the morbidity and mortality enormously and improving quality of life. While advent of non-invasive diagnostic tools like CT Scan, MRI, Ultra Sound and radio isotope studies made diagnosis of disease more specific, the latest gadgets such as video endoscopes, laproscope etc. made treatment and surgical procedures less cumbersome and simple.
Hence there is a felt need in the State to provide medical assistance to families living below poverty line for the treatment of serious ailments such as cancer, kidney failure, heart and neurosurgical diseases etc., requiring hospitalization and surgery. Available network of government hospitals do not have the requisite equipment or the facility or the specialist pool of doctors to meet the state wide requirement for the treatment of such diseases. Large proportions of people, especially below poverty line borrow money or sell assets to pay for hospitalization. Presently many people suffering from such diseases are approaching the Government to provide financial assistance to meet hospitalization expenses for surgical procedures.During the period from 14.05.2004 to 26.06.2007, financial assistance to a tune of Rs. 168.52crores has been provided from CM's Relief Fund in 55361 cases to meet hospitalization expenses for such people. From the experience gained, it is now felt that the assistance could be institutionalized so that its benefit can be accessed by poor people across the State easily and in a trouble free manner. Health Insurance could be a way of removing the financial barriers and improving access of poor to quality medical care; of providing financial protection against high medical expenses; and negotiating with the providers for better quality care.
In order to operate the scheme professionally in a cost effective manner, public private partnership will be promoted between the Insurance Company / TPA, the private sector hospitals and the State agencies. "Aarogyasri Health Care Trust" recently setup by the State Government for the implementation of the Scheme will assist the insurance company / TPA / Beneficiaries and coordinate with Medical and Health Deptt., District Collectors, Civil Supplies Department etc.
To improve access of BPL families to quality medical care for treatment of diseases involving hospitalization and surgery through an identified network of health care providers. In the initial phase, the scheme would provide coverage for the following system.
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