'New Swasthya Sathi beneficiaries to be enrolled under assurance mode'

kolkata: With a huge surge in number of new beneficiaries under Swasthya Sathi scheme as the government expanded the project to the entire population since December last year and 'Duare Sarkar' campaigns being kicked off, Bengal government has opted for 'assurance mode' for the smooth running of the project.

The government has temporarily decided to enroll all the new beneficiaries under the 'assurance mode' so that the State can directly pay the costs of their treatment to the hospitals.

This is primarily because in the 'insurance mode' of treatment the government has to pay the premiums to the insurance companies for running the scheme. It will be difficult for the government to assume beforehand what the number of the beneficiaries can be as the number of the Swasthya Sathi enrollment is ever increasing following the popularity and success of the project, the idea of which was mooted by the Chief Minister Mamata Banerjee, who wanted to ensure free of costs treatment at all the levels of government-run health facilities.

The Bengal government runs the Swasthya Sathi scheme through two modes—'assurance mode' and 'insurance mode'. Under 'assurance mode', the Health department pays all the costs of the treatment to the private hospitals after the bills are cleared by the TPA. While in case of 'insurance mode' the insurance companies pay the costs of the treatment of patients to the hospitals against the premiums that the government pays to them at the beginning of the scheme or at the time when both parties enter into an agreement.

"We did not know where the number of the new beneficiaries will reach. So, it will not be possible for us to determine the number against whom the premiums will be given. We have to declare before the insurance companies as to how many people are covered. As the scheme was expanded, the number went up. We had to pay extra premiums, if we had included the new beneficiaries under the 'insurance mode'. Hence, the new beneficiaries are covered under 'assurance mode' so that people do not face any inconveniences while availing free treatment," a senior health official said.

"For example, if we want to cover 2.30 crore families and pay an insurance premium of at least Rs 1,000 per family. We have to pay a total premium of Rs 2,300 crore in a year in advance. But in case of 'assurance mode' the government will get the liberty of paying the total costs of around Rs 2,400 crore in various phases throughout the year," the official added.