According to the Brihanmumbai Municipal Corporation (BMC), these property tax payers are the “true citizens” of Mumbai — but who often find the public health sector unattractive and therefore end up going to private hospitals or nursing homes in the vicinity of their apartments, even though it stretches their budgets.
“Middle class property tax payers may have to borrow money or sell assets to pay for hospitals,” states a draft proposal prepared by the BMC’s health department.
The proposed scheme, called Shiv Arogya Suraksha Kaavach, will provide cashless cover of up to Rs 3 lakh to all family members of property tax payers. Significantly, the BMC is considering recognising several private hospitals in addition to civic hospitals that would be able to admit patients under the health insurance scheme.
“The choice of hospitals, whether public or private, will be left to the patients. The private hospital will have the freedom to charge the patients as per their class,” the proposal states.
The chief executive officer of a private sector general insurer said the BMC could extract a discount of up to 40 per cent on the premium. At about Rs 1,500 per family post discount, the total outgo for the civic body would be less than Rs 250 crore, which is approximately equivalent to a 10 per cent rebate on property tax.
Presenting the budget for 2013-14, BMC Municipal Commissioner Sitaram Kunte had suggested that the scheme would be implemented this year. “The draft report of the scheme will be examined for implementability in the budget year,” Kunte had said.
Officials in BMC’s health department said few middle-class citizens or property tax payers availed of medical care facilities provided by the civic body’s extensive network of three major tertiary hospitals, 16 secondary level hospitals, five super speciality hospitals, 26 maternity homes and 163 primary health centres.
“Only the poor, who are not tax payers, visit these facilities,” an official said.
The civic body reckons that a large percentage of middle-class Mumbaikars do not have the yellow or orange ration cards and cannot, therefore, benefit from the Rajiv Gandhi Jeevandayee Aarogya Yojana. The proposed Arogya Suraksha Kaavach scheme could also expand the health insurance cover in the metropolis. BMC estimates that health insurance subscribers are less than 2 per cent of the city’s population.
BMC proposes to establish a network that includes registration, authorisation, authentication, treatment details and reimbursement. It is currently working on a detailed analysis of the cost to include end-to-end treatment similar to what is available in civic hospitals.