Up the rocky path to good health

Pithoragarh, Oct 24 (ANI): Soon after the controversy evoked by the poverty line figures submitted to the Supreme Court by the Planning Commission last month, Montek Singh Ahluwalia, Deputy Chairman of the Commission, put forth, as a part of his damage-control exercise, a proposal for de-linking of the food entitlement and other social programmes from the current poverty line derived from the "factual" findings of Tendulkar Committee.

He also suggested the adoption of a new methodology for the determination of the poor households in rural areas that would be based on the socio -economic caste census. f approved, this proposal will extend national programmes to people who have not been listed below the poverty line but are living under similar stress.

According to Mr. Ahluwalia, a solution to unfetter the poor from health and education stress is the correction of service failure under the Right to Information and the National Rural Health Mission.

Undoubtedly, creating a broader base of beneficiaries will help in uplifting the rural and marginalized communities but what about the hindrances, which are still confined to the regions that are geographically inaccessible? Where solutions have given birth to new problems and deprived communities are left alone to find answers for themselves? Remote regions of Uttarakhand are home to communities who are living tough lives coping with ineffective government aid.

Four years ago, on April 1, 2008, the Ministry of Labour and Employment, Government of India, launched a landmark health scheme nationwide called the Rashtriya Swasthaya Bima Yojana (RSBY) to provide health insurance coverage to Below Poverty Line (BPL) families. It was aimed at insuring BPL households from major health shocks that involve hospitalization.

Things were near perfect at the publicity level that successfully reached the doorstep of the beneficiaries living in close proximity; but failed to address the needs of the communities located in the far flung areas like Pithoragarh, an isolated district in Uttarakhand.

Under RSBY, a BPL family is issued a smart card against a nominal fee of Rs 30 that carries the name of the head of the family, age and fingerprints of the members. But the cards, which were supposed to relieve the poor from worries, turned out to be a big nuisance with numerous faults and discrepancies, as the unsuspecting villagers found to their dismay.

Issuing authorities' allotted cards to the BPL families that carried either the incorrect name or the wrong age unveiled the lack of smartness while issuing these "smartcards". Several other knots added to the misery: improper functioning of smart card readers installed in various hospitals, inaccurate thumb impressions and card renewal problems, among others.

Considering the several faults, complaints were only to be expected. The response to them has been as simple as the success of such schemes on paper. The geographical location of this region has limited the scope of facilities to the beneficiaries in terms of helping staff, communication services, transportation and most importantly, awareness.

People living away from the development ambit lack awareness. Help lines exist but how to make use of them is a mystery for people living there. Most of them do not know about the complaint-related procedures and those who know and were brave enough to go ahead with them, have myriad experiences to share.

Getting these annual valid cards reformed requires a minimum time period of four months with regular follow up to a distant district office, which also requires huge investment in terms of money and time. That one will get an error-free card after all this hard work is not guaranteed.

Several BPL families, even after the four years of the launch of the Program, are still awaiting enrollment. Members of such families residing in mountainous regions often suffer accidents and require immediate benefits of such schemes, which is not provided for in the current provisions.

On the other hand, there is a long list of BPL households which have their names registered in the corresponding government list but have missed out the enrollment due to inappropriate communication. In other cases, families with BPL cards do not have their names in the government directory of BPL families.

Who, then, is benefiting from the scheme? There are indications of a lack of coordination between the Health Department, Gram Panchayat and the Insurance Companies. The faith of the common man in such promising schemes has been irreversibly shaken.

The debate points to the current hot topic of the country - corruption. Few with the knowledge and the means illegally extract money from the unsuspecting many. Instead of paying the nominal fee of Rs 30, a few BPL families have paid Rs 100 to get their right - needless to say, by the wrong means. No written complaints have been registered, people merely talk about the problems amongst themselves.

People's interest in the government's undertaking is flagging. In the present times of high inflation, when medicines and doctor fees are so high, Rs 30, 000 would unlikely be adequate to support the health of five members of a family. If the bill crosses the sanctioned amount, beneficiaries have to pay the excess amount. They hesitate to get embroiled with the daunting procedures of an error bound card, valid for only a year and accessing medical aid restricted by several terms and conditions.

Undeniably, the scheme was launched with great intentions, which included some of the best measures to benefit the destitute families. Great care was taken by the drafters to make it a foolproof plan by setting the base for it derived from the learning of current and past health insurance schemes.

The Charkha Development Communication network feels that the cracks at the execution level require streamlining. Including a wide range of beneficiaries is a priority, as is making benefits available to them by breaking every barrier. A needy soul living in the difficult terrain is still awaiting inclusion in the development schemes at both planning and implementation stage. Is anybody listening? By Dinesh Pant(ANI)