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Dr KK Aggarwal
New Delhi, July 8, 2018:
Ayushman Bharat is National Health Protection Scheme by the government. The rates for LSCS are 9000/-. The medical profession says our cost is 57000/- Then what is the answer. Is it the concept of cross subsidy.
Cross subsidization is the practice of charging higher prices to one group of consumers to subsidize lower prices for another group.
Suppose Mr X goes to dinner with two of his friends Y and Z. X’s meal costs 100/-, Y’s meal costs 200/- and z’s meal costs 300/-. The total bill is then 600/- and everyone decides to split the bill evenly, for 200/- each. X’s meal is undercosted. Z’s cross-subsidizes Alex for 100/-. Y is neither cross-subsidized nor cross-subsidizes anyone else.
TN-IMA has shown that the real cost of a cesarean in private sector is 57515/- ( say 57000 for calculations).
In Ayushman Bharat the government wants to pay 9000/- ( 10% extra by states, 15% extra for NABH accredited and 10% extra for DNB hospitals). Even if it comes to 12000, the establishment will have to provide a subsidy of 45000/- Rs.
How will the establishment cover the cost?
Ayushman Bharat covers 40% of the population
- The government can give 40% concession in taxes to such establishments ( property tax, income tax, service tax, land at concessional rates where applicable etc)
- All hospitals who are given concessional lands instead of free services can be asked to register under the ayushman bharat
- Or the rich must provide the cross-subsidy to the poor. The package rates of the rest 60% should be 50% higher than the derived prise. For example, 100.000 for cesarean.
Note: The above is a concept. The actual prises will vary with the average cost derived when all procedures are included.
