No Pain, all Gain?

UP STETHOSCOPE

Suspecting they are being scammed, at least 18 insurance companies, including four in the public sector, have delisted more than 150 hospitals in Delhi and the National Capital Region (or NCR, which is basically the Delhi region) from their designated list for Mediclaim insurance. Could a virus strain of this scam have already affected the hospital scheme that entitles you to cashless medical facilities in Goa? The news broke last week and the position on this could change. Your periscope (like a submarine) should be up and looking. In this case, you would need a stethoscope to grope for the evidence. You should like a doctor be able to feel the heavy breathing of anticipation within the corridors of government officialdom and the medical fraternity. The pounding of heart beats. The hard medical facts are, your government reimbursed a huge Rs 11,64,02,329 in 2008-2009 to 16 of the 21 empanelled hospitals under Mediclaim. In 2009-2010 up till February 28, 2010 the government paid Rs 8,04,16,423 to 18 of the 21 hospitals under the Mediclaim scheme (see list for actual details). The government owes an additional Rs 5,73,14,125 to 14 hospitals for the period 2009-10. All in all that makes it a mammoth Rs 25,41,32,877 the government paid a clutch of hospitals. You sense some fiddling here? O course, you do, because either we are a very, very ill community and must be all laid up which would explain the sussegad in us. Or, as you rightly diagnosed, it must be a few hundred unwell who are making an even smaller group of people glowing with good health extremely rich with all that moolah. Who said wealth does not bring happiness? Because even a pinprick of the Rs 25,41,32,877 has to make you feel good. Call it wellness.

Dr. DIAGNOSTIX

A doctor’s diagnosis is that the list itself of sick persons who are asked by the Directorate of Health Services to reimburse the hospitals directly is very small. The reasons are obvious. But the list of sick given the benefit of a cashless transaction is huge. The reasons are obvious again. No transparency at this level means more cash for officialdom and hospitals. In an ironic way cashless for you means more cash for them. That’s why the 18 insurance companies have a deep suspicion and have acted before the virus spreads. Let’s see what happens in Goa next.

UNDER INTENSIVE CARE

HOSPITALS IN GOA

In the two financial years 2008-09, 2009-10 (up to February 28) Apollo Victor Hospital, Margao was paid Rs 3,76,98,886 and Rs 2,31,76,294; Om Urology, Panjim Rs 16,93,772 (08-09 only); Chodankar Hursing Home, Porvorim Rs 70,37,216 and Rs 31,60,789; Goa Manipal Hospital, Dona Paula Rs 2,80,573 and Rs 8,34,672; NUSI Hospital, Cuncolim Rs 41,91,702 and Rs 2,56,538; Vivus, SMRC, Vasco Rs 80,10,911 and Rs 37,36,403; Vrundavan Hospital, Mapusa Rs 28,01,801 and Rs 40,12,195; Grace Cardia Care, Margao Rs 4,97,927 (09-10 only); SMRC Vasco Rs 95,449 (09-10 only).

HOSPITALS OUTSIDE GOA

KLES Hospital, Belgaum Rs 2,85,53,156 and Rs 1,62,38,625; RG Stone, Mumbai Rs 29,62,421 (08-09 only); Tata Memorial Hospital, Mumbai Rs 72,65,972 and Rs 75,05,163; Wockhardt Hospital, Bangalore Rs 77,96,635 and Rs 54,64,240; Kasturba Hospital, Manipal Rs 14,00,117 and Rs 17,47,054; Ruby Hall Clinic, Pune Rs 3,11,715 and Rs 1,00,077; Sankara Netralaya, Chennai Rs 7,49,837 and Rs 5,96,368; Santosham Chest, Chennai Rs 84,743 (08-09 only); Neogen, Bangalore Rs 55,62,872 and Rs 1,24,852; Wockhardt Hospital, Mumbai Rs 2,63,507 (09-10 only); Manipal Heart Foundation, Bangalore Rs 1,18,796 (09-10 only); Belgaum Cancer, Belgaum Rs 1,14,474 (09-10 only).

REIMBURSED IN 2008-09 Rs 11,64,02,329

REIMBURSED IN 2009-10 Rs 08,04,16,423

TOTAL: Rs 19,68,18,752

REIMBURSEMENT PENDING WITH GOVERNMENT (2009-10)

Apollo Victor Hospital, Margao Rs 1,75,55,000

Chodankar Nursing Home, Porvorim Rs 9,08,665

Goa Manipal Hospital, Dona Paula Rs 10,45,000

Vivus, SMRC, Vasco Rs 50,78,000

Vrundavan Hospital, Mapusa Rs 15,05,000

Grace Cardia Care, Margao Rs 5,60,000

Campal Clinic, Panjim Rs 41,60,000

KLES Hospital, Belgaum Rs 1,43,40,000

Tata Memorial Hospital, Mumbai Rs 6,55,000

Wockhardt Hospital, Bangalore Rs 24,28,000

Kasturba Hospital, Manipal Rs 6,65,000

Sankara Netralaya, Chennai Rs 4,25,000

Neogen, Bangalore Rs 78,09,460

Belgaum Cancer, Belgaum Rs 1,80,000

TOTAL: Rs 5,73,14,125

GRAND TOTAL: Rs 25,41,32,877


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