The Hindu : Tamil Nadu News : Paying for chronic ailments

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Tuesday, Jun 03, 2008
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Tamil Nadu

Tamil Nadu

Paying for chronic ailments

Ramya Kannan and R. Sujatha

The increased cost of treatment is eating into the already-stretched finances of the middle class

’Some insurance schemes do not cover outpatient treatment’

If regular healthcare is difficult to afford, living with a chronic ailment can literally destroy someone .

As a nation that is said to be moving into a ‘non-communicable diseases’ epidemic mode, the numbers with diabetes, cancer, hypertension, stroke, cardio-vascular diseases, kidney disease, HIV, and stroke are climbing. A person with even three of these closely linked diseases may require up to Rs.5000 a month, doctors say.

But can the great Indian middle class afford this?

Chandramouli, a retired Central Government officer, is a beneficiary of the Central Government Health Scheme, which covers retired employees’ health care costs. He and his wife have cancer. “The cost of my wife’s medicines, which went up from Rs. 8,000 last year to Rs. 9,000, are reimbursed by the CGHS. I have not gone to the CGHS dispensary for six months now as there are no specialists to treat me.”

Srinivasan,* a retired state government employee, has been living with diabetes for over 35 years now. His wife, Soundaram,* has diabetes, heart disease and renal problems. Her medicines alone cost Rs.2500 per month and she has been unable to afford surgery. She says: “My husband’s monthly pension is Rs.900. We have had to sell our house in Thanjavur and move to Chennai. Every year, he needs to be admitted to a hospital for foot-related complications. That cost about Rs.35,000. We have some meagre savings left. After that, I have no idea how we can go on…”

“The thing with chronic diseases is that treatment gets more expensive with time,” V. Mohan of Diabetes Specialities Centre, explains. As the disease progresses, more expensive drugs will have to be prescribed. Complications can also arise, requiring hospitalisation. His patients, even some relatively affluent ones, have sold houses and businesses to pay for health care. As for pensioners and retirees, their resources are limited.

The wife of Y. Ebineizer Arokiyaraj, a senior official with the Meteorology department, is undergoing dialysis. While dialysis costs between Rs. 900 and 1,100, costs such as room rent and other necessities are not factored into the reimbursement package, he says. Tanker Foundation is one of the few organisations that gives poor patients with renal failure access to dialysis.

“Our criterion is that people we help should have a monthly salary of less than Rs.10,000, but there are a number of people who earn only a little more and need help too,” says Stella Mathew, the Foundation’s project director.

They provide dialysis at Rs.400 and also help the patient to get tests done.

Even for those with some form of medical insurance, insurance inflation is up to about 13 per cent every year for hospitalisation, says Sheela Anand, general manager (southern region), TTK Healthcare Services. She points out that some insurance policies do not cover outpatient treatment; moreover drugs for regular maintenance cost a lot.

The increased incidence of lifestyle diseases and rising prices has not led to a big increase in the number of people taking insurance, says V. Sekar, GM of United India Insurance.

He agrees that continued inflation will make it difficult for people to afford the higher premiums.

*Names changed on request

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