Govt may allow CGHS to die

Health dept may not allocate Plan funds from next year

A new health insurance system for central government employees is likely to replace the Central Government Health Scheme (CGHS), covering over 4.4 million beneficiaries.

The government spends Rs 500 crore per annum on the CGHS, which is a contributory health care scheme with members being the serving as well as retired central government employees.

The scheme involves stocking and running a network of 250 CGHS clinics that provide general physician services including free medicines.

However, in an internal note the health department says from 2006, no money will be allocated under the Plan head for the CGHS.

Complaints of poor emergency services, non-availability of medicines and delays in reimbursement led to some liberalisation in the CGHS some years ago. These included extending the CGHS network to some private hospitals for specialist health services and purchase of drugs from the open market. But discontentment with services continued.

In May this year, the government set up a committee under the chairmanship of former Cabinet Secretary PK Kaul to make the CGHS more "user friendly".

Discussions in this committee suggest that while the government may not be able to wind up the CGHS, it can be replaced with a new health insurance system, with the CGHS eventually being turned into a registered society, or being merged with the public hospital network of the railways ministry and the Employees State Insurance Corporation.

The committee has also suggested that after being given functional autonomy, the CGHS can become an independent public entity, maybe even floating of shares.

However, the trend of the discussions has raised the hackles of the Left parties. The proposed September 29 countrywide strike called by the CPI(M) and the CPI-affiliated trade unions""the CITU and the AITUC"" is also against the "privatisation of the CGHS".

Central government employees unions say the problem with health insurance is it will not apply to pensioners above 70. And it will cover only those conditions requiring hospitalisation. Subscribers will have no recourse to outdoor treatment.

Chronic and out-patient dispensary conditions will be beyond the pale of the proposed scheme.

The committee is mulling ways to provide segregated service. Currently, freedom fighters, MPs, ministers and even journalists are covered by the CGHS. There is a huge differential in the quality of service. Soon, the committee says, segregated service""a separate scheme for employees of the Supreme Court"" should be created.

But Left parties say the CGHS is mostly used by pensioners and they will be denied access to health facilities.

They also cite the US experience of health cards where medical treatment is costly and beyond the reach of the very poor. They say they will oppose the replacement of the CGHS by health insurance. The central government employees are highly unionised.

Throwing the baby out with the bath water

The government spends Rs 500 crore per annum on the CGHS, which is a contributory health care scheme

The scheme involves stocking and running a network of 250 CGHS clinics that provide general physician services, including free medicines

The Left parties and its affiliated trade unions have announced a nationwide strike against the privatisation of the CGHS

The Left parties say they will oppose the replacement of the CGHS by health insurance