By Dr KK Aggarwal
President CMAAO and HCFI
I saw a report of Rema Nagarajan in TOI that a 12 years old Sameer from Bihar’s Muzaffarpur is suffering from aplastic anaemia needs Rs 12 lakh for a bone marrow transplant but inspite of being entitled under both Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Rashtriya Arogya Nidhi (RAN) he is getting no relief.
The hurdles are that Ayushman Bharat does not cover bone marrow transplant and an office order says that he can nor be covered under Rashtriya Arogya Nidhi (which provides up to Rs 15 lak coverage for serious illnesses) because he is covered under Ayushman.
The job of the government is to help and not find the loopholes. Government orders cannot supersede the spirit behind the schemes. Its like that the rules cannot supersede the act.
I have another patient Mithilesh Kumar from Bokaro, Jharkhand. He is a contract worker. He was operated for implantation of CRTD St. Jude Device pacemaker at CMC, Vellore in 2014. At that time, he managed to arrange the amount for operation by selling his property. Now, battery of the pacemaker is to be replaced. He has Ayushman Bharat card, but it does not cover the expenses of battery replacement. He has written to PM, Narendra Modi for help.
Not covering the battery replacement does not make sense. If you have decided to cover a pacemaker it is understood that the battery would last 5-15 years depending on the type of devise and second or third replacement need to be covered.
Where should a poor man go for the clarifications. Courts are already overloaded with cases. Everyone cannot afford the courts also. Such powers should be given to district magistrate or the CMO to handle and interpret the government orders in the right spirit.
I am marking this email to Dr Harsh Vardhan Ji, PM Office and Dr Vinod Paul for positive interventions.