In an effort to ensure that the poor can access quality Covid care, municipal corporations in major cities have got into the act. All Covid positive cases are brought under their umbrella and they, in turn, assign patients to empanelled hospitals that are close to the patient’s residence. As a result, a number of patients — poor, rich or middle class — have received good care for free. For a country where close to 70 per cent of healthcare expenses are borne by the people themselves — pushing many into debt and poverty — this model has proved to be a saviour for many in Mumbai, Bengaluru and Chennai (not so much Delhi). Have we hit up a model of universal healthcare, one that can better Ayushman Bharat?

Ayushman Bharat is based on targeted coverage; only those identified as poor under the Socio-Economic and Caste Census are to benefit. Besides exclusion errors, hospitals can charge patients under heads not covered by insurance. In the Covid municipal model, there is no such complication. Provided the municipal quota beds are available, patients’ medical expenses and nursing charges are covered by the State. There are delays in transferring the patient to the hospital after the report is confirmed as positive — owing to poor coordination between the laboratory and municipality. The maze of code numbers and OTPs generated in the process can be befuddling for a poor or tech-unsavvy patient in a state of anxiety. But these matters can be sorted out.

Once Covid abates, a formula that works to the benefit of private hospitals, patients and the government can surely be arrived at. Private hospitals should not be deprived of incentives to operate. The courts have ruled in the case of Delhi that private hospitals ought to provide free care to a proportion of inpatients and outpatients in lieu of getting land at throwaway prices. We are, by default, seeing this principle being put into practise.

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