TN should cover Covid-19 testing under CMCHIS

Rajalakshmi Ramprakash Joe Arun | Updated on March 31, 2020

Tamil Nadu has been lauded for its proactive response to curtail the coronavirus spread, while at the same time, it has come under criticism for turning away patients who do not fit the three criteria required for testing — cough, fever and breathing difficulties — combined with a travel history to affected nations. While there are four designated centres in Tamil Nadu, if larger screening and testing procedures need to be introduced, two crucial questions remain — which diagnostic centres should be allowed to do testing, and who will bear the costs?

The TN Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS), unlike any other scheme (even the PMJAY), has the distinct advantage of providing for diagnostic procedures irrespective of whether or not it leads to hospitalisation. According to a World Bank report, more than half the population of Tamil Nadu (14.2 million families) are already enrolled in the CMCHIS. The government pays ₹699 per enrolled family (₹8.6 billion per annum in total) as premium to the insurance underwriter. Post 2017, when the CMCHIS was integrated with the PMJAY, 38 diagnostic procedures are covered under the scheme and more than 238 private diagnostic facilities empanelled. Unlike surgical and medical procedures, using the CMCHIS for diagnostics has remained low (less than 5 per cent of total claim value in 2017).

It might be an efficient idea to provide Covid-19 testing facilities under the CMCHIS. The advantages are many. First, the empanelled diagnostic centres, especially private ones, would have already been checked for quality standards during the enrolment process. Second, coverage under the CMCHIS would reduce out-of-pocket expenditures for patients at a time when the test’s costs at primary level is ₹1,500 and confirmatory level is ₹5,000. The costs may go up as we continue to import the probes from Germany. Third, with the government being the final authority, it can ensure that the existing facilities at private diagnostic centres are monitored closely. Fourth, the scheme would shed its image of helping only for high-end tertiary level cases.

The writers are with the Loyola Institute of Business Administration

Published on March 25, 2020

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