Thiruvananthapuram: As medical costs soared and health insurance still a long way from becoming a habit, the introduction of Karunya Benevolent Fund was seen as a boon for poor patients. Now, innumerable instances have come to light of affluent patients, with the connivance of private hospitals, cornering the benefits of the Fund meant for the have-nots.
An audit conducted by the Comptroller and Auditor General (CAG) has found that certain private hospitals, including cooperative hospitals, had charged in excess of the package rates, and claimed the difference amount from the beneficiaries concerned. Take EMS Memorial Co-operative Hospital & Research Centre, Perinthalmanna, for instance. Here, most of the patients test-checked by the CAG audit team had given undertakings to the effect that they needed additional facilities such as rooms, better quality stent, consumables, and all that money could buy.
But what triggered the suspicion of the team was the willingness of the patients to pay for all the costly equipment and luxury. “It was not ascertained whether such patients actually needed assistance from KBF, as they were capable and willing to pay these amounts,” the CAG concluded in its Revenue Sector report for 2018. In nearly 20 cases, patients had paid more than Rs one lakh from their pocket, in addition to the assistance they received from the Fund. In one case, at EMS Memorial Co-operative Hospital & Research Centre, a patient shelled out an extra Rs 4.17 lakh of her own money. The CAG has issued directions to the state government to keep out patients who can afford costly care from the purview of the Fund.
The Karunya Benevolent Fund was constituted in 2012 to provide financial support to the poor for the treatment of cancer, kidney, heart diseases and also for palliative care, by utilising the net proceeds from the draws of ‘Karunya’ and ‘Karunya Plus’ lotteries. The CAG also noted that by providing treatment for affluent patients under the KBF scheme, these accredited private hospitals had violated their agreement with the government to offer cashless treatment to small income families.
That the affluent were securing an increasingly large share of the fund was reflected in another finding. Hundreds of those who had managed, pulled as many strings they could, to secure assistance from the fund eventually decided not to take it. The CAG had come across 1520 such cases. They were not happy with the government hospitals chosen for them, and instead opted for costly private hospitals.
The interesting part is, the money that the fund had transferred between 2012 and 2016 to these government/autonomous hospitals - even big names like RCC and Sree Chitra Thirunal Institute for Medical Science and Technology (SCTIMST) – have not been returned. No one has asked them for the money, either; the Fund guidelines say that the unutilised money has to be refunded. So much for commitment to social welfare.