Hyderabad Debates Health Insurance Model As Public Hospitals Decay

Thursday, July 18, 2013

On February 21, during the afternoon rush hour in a busy shopping center in downtown Hyderabad in the southern state of Andhra Pradesh, two makeshift bombs packed with bolts and nails were detonated in one of the deadliest terrorist attacks in the city’s history. Over 100 people were injured by the blasts, and many were transported for treatment to Osmania General Hospital, the largest public hospital in the city.

In the hours after they arrived at the hospital around 25 of these patients, some of whom were in critical condition, were transferred to a nearby private hospital. When asked to explain this risky patient transfer, the Osmania doctors pointed to broken equipment and a shortage of necessary drugs.

“The wards were in deplorable condition” and the hospital simply couldn’t handle the number of patients, said a report sent in March to the state’s chief minister, Nallari Kiran Kumar Reddy, by the Alumni Association of Osmania Medical College.

Osmania Hospital was not an isolated case, but part of a long-term trend of neglect in the state’s public health care sector. The usual suspects blamed for the hospital’s failure included corruption in the Andhra Pradesh Medical Services and Infrastructure Development Corporation (A.P.M.S.I.D.C), the state government’s equipment procurement agency, and lack of funding. Some Osmania doctors, however, say that Andhra Pradesh’s popular health insurance program, Aarogyasri, also played a part.

Aarogyasri, founded in 2007 by then-Chief Minister Y.S. Rajasekhara Reddy, is the first program in India to provide government-subsidized health insurance to poor families in India. It covers all families with a yearly income of less than 60,000 rupees ($1,000), meaning that almost 85 percent of the state’s population qualifies. N Purendra Prasad, a sociologist at the University of Hyderabad, and his co-author, P Raghavendra, argued in an essay in theEconomic and Political Weekly, that it was the decisive factor in the Congress Party’s victory in the 2009 state elections for the Legislative Assembly.

Source: The New York Times (link opens in a new window)

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