Vishwanathan S
(we have attempted the following as seed for thought – every citizen is requested to improve upon it and take it forward with the appropriate authorities so that it becomes a reality – Thank.
PART I
An outline of Social Security Scheme for unorganised labour, destitute, aged & housemakers
Basic requirement –
- Everyone would be identified by his/her Aadhaar Card.
- The Scheme is voluntary—it is a self-financing scheme.
- One should have a Bank Account.
- A minimum annual contribution of Rs.100; thereafter in 50s to be paid through Bank Account by way of ECS Mandate.
- A minimum pension of Rs.10, 000. The Pension is meant for the sole benefit of the individual. With the death of the beneficiary the benefit would cease. Nothing like nominee.
- On attaining the age of 60/65 or earlier if totally disabled the individual would be entitled to minimum Pension.
- For higher contribution formula should be evolved by the experts to pay proportionately higher Pension i.e. above Rs. 10,000.
- Governments would contribute an aggregate amount annually towards this fund as Grant.
- To further augment the Fund individual/organisations can contribute; and the amount so paid would be entitled to 100% from tax. It should not be 50% as under the Income Tax. It is ridiculous to have 50% exemption. Government should be graceful and not stingy.
- The amount of Rs.100 p.a. may strike some as ridiculously low premium. It is not so. We have the advantage of the number. Presently, even with an annual premium of Rs.12 one is entitled to a compensation of Rs.1 lakh.
THE ABOVE IS MEANT AS A SEED FOR THOUGHT FOR THE RULE MAKERS. PRAY AND TRUST THAT ANY IMAGINATIVE GOVERNMENT WOULD GIVE A THOUGHT AND IMPLEMENT IT. Corrective steps if any can be introduced as we gain experience.
Hope PMO Secretariat would give a serious thought and act.
PART II
On a conservative basis, Government would be able to raise a revenue of around 70-80 lakh crore revenue through this System. This huge sum can be made use for bringing in Health-cum-Social Security Scheme for the public. I have tried to touch upon this in a very brief manner. They are meant to be as seed-for-thought.
Medicare and Social Security
“When every citizen of the country is healthy, the nation would be healthy” – Narendra Modi
“What makes for a good healthcare system is universal and adequate access without excessive burden. There is one possible solution for providing such coverage”.
Please read the following suggestion and decide whether it is worth considering.
Following is a humble attempt to suggest a scheme whereby every single citizen of our great country gets the coverage of health-CUM-death insurance and Pension, with least hassles.
Some basic assumptions
Any major scheme such as “Universal access to healthcare” should necessarily be a joint public-private venture.
a) The implementing agencies would be responsible to the governments for the successful execution of the programme.
b) Even the most illiterate/ignorant citizen should be able to avail of the health/insurance scheme easily. All that one has to do is to flash his/her Identification Card in any of the recognized hospitals/institutions/authorized OR medical attendants of ones choice in any part of the country to avail of the benefit. The citizen would not be required to pay single paise to any one for the medical services.
c) In case of any grievance watch dog personnel with adequate powers should be available in all the Centres at hand that would come to the spot and resolve the problems/inadequacies, if any.
d) Also visitors to this country should be able to avail of medical facilities against a prescribed fee on arrival. This will be in keeping with our motto अतिथि देवो भव.
We have attempted to make suggestion as simple as possible. No doubt it would need further improvements at the hands of experts.
Without going into the inadequacies and inequalities of the existing Social Security Legislations, a highly simplified Social Security Scheme is being suggested which would cover each and every citizen of this country. As reported in a Mumbai Based prominent Newspaper one of the CEOs of a prominent Insurance Company had said, “It would be impossible to give insurance coverage beyond the age of 75”. In the proposed legislation it would be possible to give insurance coverage even to centurions.
Fund requirement
Indian population is around 125 crores. Assuming that we need an annual premium of Rs.2000 per citizen, we would need Rs.2.5 lakh crores per annum. We may err on the safer side and assume the fund requirement as Rs.4 lakh crores per annum.
Note—you can tag it on with other Schemes like Pradhan Mantri Suraksha Bima Yojana, Atal Pension Yojana already under consideration/force. If need be the individual may be required to contribute a token sum of say Rs.12 p.m. or Rs.120 p.a.
Since we have the advantage of the numbers it is assumed a premium of Rs.2000 per head per annum should be adequate to meet the cost of treatment-cum-insurance.
Scheme in brief
a) An authority would be established known as “Samaaj Suraksha Adhikari/Social Security Authority” – SSA for short. He would be supervised by Board of Governors.
b) SSA would recognize periodically series of Hospitals like Government/Cantonment/Municipal Hospitals/ESI/Government Employees Health Schemes and private hospitals like Bombay Hospital, Apollo Hospitals, Jaslok, and similar institutions for medical treatment/hospitalization.
c) Similarly, he would recognize Authorized Medical Attendants (AMA) and CHEMISTS all over the country.
d) SSA would prescribe a realistic and uniform rates—to be reviewed periodically –
i) Hospital charges and services like x-ray, MRI, blood test;
ii) Fees for the services of the AMA; and
iii) Prices of items to be supplied by the Chemists.
e) Beneficiaries needing the services would present themselves before the recognized Hospital of one’s choice for treatment. Aadhaar card/Driving Licence/Voter ED etc. would serve as the ID.
f) The beneficiary would be treated as a paying-patient but would not be required to pay single paise for one’s treatment. All the costs would be borne initially by the Hospitals/Institutions themselves. They would periodically claim reimbursement from the SSA. As paying patients they would be entitled to a (decent) Paying Ward. Those desirous of treatment in Special Wards should be required to pay the entire charges from their own pockets.
g) In the case of disablement or death a very liberal compensation/pension can be given to the victims or nominees. It should be around 5 or 10 lakhs and Pension should be around Rs.10,000 p.m. to be paid through Banks or Post Offices.
h) Similarly Authorized Medical Attendants (AMA) would be recognized, rates for various services would have been prescribed by SSA. They would not charge the patients. They would also get reimbursement from SSA periodically.
i) For supply of medicines prescribed by the AMAs Chemists/Druggists/Pharmacy would similarly be recognized by the SSA – who in turn will get reimbursement from SSA against medicine (at the approved rate) supplied.
j) Watch dogs to be appointed at different strategic locations, who would keep a watch by visits to Hospitals etc. so that possible misuse of the Scheme is kept to the minimum. Also they should be available on call 24×7 to the citizens so that they can come personally to the spot and remedy the situation when contacted by the concerned citizen (beneficiary) by phone/mobile/in person.
k) Thus all the citizens would be entitled to benefits as befitting a contributor. Those who want specialized treatment, as stated above would be required to bear the entire expenditure themselves.
I) There should be a feedback system so that the SSA receives information about the quality of services rendered by the Institutions and AMAs.
ANY SCHEME HOWEVER METICULOUSLY DRAWN IS BOUND TO BE MISUSED BY A MICROSCOPIC PERCENTAGE OF BENEFICIARIES. APPREHENSION OF MISUSE SHOULD NOT BE A GROUND FOR OUTRIGHT REJECTION OF THE PROPOSAL! WHILE ALLOWING FOR THIS LEAKAGE, WE SHOULD TRY TO CURB THIS MENACE TO THE EXTENT POSSIBLE BY APPOINTING WATCHDOG TEAMS/FLYING SQUADS CONSISTING OF SOCIAL WORKERS ARMED WITH WIDE POWERS, SOME OF WHOM IN TURN CAN ALSO BE DISHONEST TO SOME EXTENT. Let us not shelve this idea on the ground that the Scheme is likely to be misused. Even if there be say 10-15% misuse the remaining 85-90% would stand to gain immensely.
In order to reach the rural and neglected areas the SSA can think of giving incentives by way of reimbursement at somewhat higher rates. The doctors opting for posting at such places can also be given some meaningful attractive incentives. It will also be a good idea that SSA ascertains from the patients/beneficiaries the quality of services rendered by the recognized institutions/hospitals. The subject is so wide and complex that one can go on giving more and more suggestions – but it would still be inadequate. Let us embark on this Sacred Project. As we get going, we can further improve and fine tune the system.
These are details to be worked out in more precise terms.
It is only a cryptic suggestion for the consideration of well-wishers, social workers and legislators to consider the proposal and to come out with a viable but simplified legislation. Various checks and balances will also have to be formulated so that there is least fraud. But we should not shelve the project.
To sum up
1. We have a central authority in place known as Samaj Suraksha Authority.
2. Banks collect by way of TDS against withdrawals and place the amount of around Rs.4 lakh crores at the disposal of the SSA.
3. It is funded by the consumers. The more you consume, more you pay and less you consume, you pay less. However, the benefit is same and uniform for all.
4. Governments, Individuals, Corporates and philanthropists can augment the Fund. Such donors should be exempted automatically 100% on such donations.
5. SSA recognizes Hospitals/Institutions/AMAs/Chemists. They get reimbursement from SSA.
6. A common tariff laid for the entire country and reviewed periodically.
7. Citizens avail of these cashless services at the place of their choice.
8. Powerful Watchdogs/Flying Squads are there to oversee the function.
9. For Rural Areas special extra incentives are given so that greater numbers of institutions/hospitals/AMAs are encouraged to move to rural areas.
10. Foreign visitors can be extended this benefit against a Flat Premium payable on their arrival.
Lastly, once the Scheme is implemented, it is continuously monitored and improvements introduced from time to time.
As suggested by many with the enormous fund at the disposal of the Government, it can bring a Social Legislation wherein anyone on attaining age of 60 or becoming eligible can get a Pension of 8000/10000 in addition to a decent lump sum. In the case of death the nominee can be given a lump-sum and a Pension of 4000/5000.
Lastly a humble request. Fellow citizens are at liberty to improve upon the Presentation and dynamic persons can seek the views and supports of the public through “Change.org” or “Awaaz.org” or some such medium. THANKS AND REGARDS.
May our country prosper!!!
Let Almighty show us the best way!!!
HEALTH CARE FOR ALL
Each one of is a CONSUMER. It is the duty of the consumer to take care of the health of the SERVICE PROVIDER.
CONSUMER would contribute a percentage of money (in most cases as reflected by the sums withdrawn from the Banks) spent for getting services from the Service Provider. Higher one consumes, higher the individual pay.
Create an environment whereby everyone is forced to open Bank Account(s) – Government has already taken some steps towards this. So that necessary funds can be raised by way of TDS at the stage one withdraws money from the Banks.
Fund Requirement – Indian population is ______ assuming that
