Veterans are facing significant challenges with the Ex-servicemen Contributory Health Scheme, as delays, inadequate infrastructure, and low reimbursement rates threaten their access to quality healthcare.
When the Ex-servicemen Contributory Health Scheme (ECHS) was launched on April 1, 2003, veterans were promised quality healthcare that would honor their sacrifices. The scheme’s motto—“Accessible, affordable, and efficient healthcare to the ex-service personnel and their dependents”—instilled hope among veterans and their families.
However, nearly two decades later, many veterans are left questioning whether this noble vision has been realized. Common issues such as delays in reimbursements have forced many veterans to pay out of pocket for immediate medical needs, undermining the very purpose of the scheme.
The infrastructure supporting the ECHS is inadequate, with polyclinics often understaffed and essential medicines frequently unavailable. Specialized services are scarce, leading to a perception that the government views ex-servicemen as an unwanted burden rather than valued citizens.
Compounding these challenges are the empanelment issues that veterans face. Private hospitals are increasingly reluctant to treat ECHS beneficiaries due to low reimbursement rates and persistent payment delays. As a result, many hospitals have ceased empanelment and cashless services for ECHS beneficiaries, leaving retired servicemen to either pay out of pocket or seek alternative care options.
Hospitals have reported that the reimbursement rates for services under the ECHS, which are often aligned with Central Government Health Scheme (CGHS) rates, have not been revised in years. This stagnation has rendered the scheme financially unsustainable for many healthcare providers. The combination of low reimbursement rates, administrative inefficiencies, and a backlog of claims has led to a significant erosion of trust in the ECHS, which was designed to honor and care for those who served the nation.
While the government has previously taken action against hospitals demanding advance payments, the broader issue of payment delays remains a persistent challenge. Organizations such as the Association of Healthcare Providers of India (AHPI) have issued ultimatums to the government, threatening to halt cashless services for ECHS beneficiaries if outstanding bills are not addressed. Veterans and their representative bodies continue to advocate for a comprehensive overhaul of the ECHS system to tackle payment backlogs and enhance healthcare infrastructure.
Digital and administrative inefficiencies further complicate the situation for veterans seeking timely care. A particularly concerning issue is the regional disparity in access to quality healthcare. Veterans residing in remote or rural areas face significantly greater challenges compared to their urban counterparts. The referral system is often cumbersome, delaying critical treatments, and there is a lack of clear policies regarding emergency treatment or surgeries.
Many ECHS polyclinics, especially in rural and semi-urban areas, suffer from insufficient facilities. Efforts are ongoing to acquire land and construct new polyclinics, but the failure to effectively navigate the E-MDMS system or adhere to proper procurement protocols has resulted in chronic shortages of essential medicines.
Furthermore, officers at various levels may misinterpret or misapply ECHS guidelines and standard operating procedures (SOPs), leading to delays or denials of rightful services to beneficiaries. This ignorance or failure to process approvals in a timely manner negatively impacts patient care, particularly for emergency and specialized cases.
To address these issues, the ECHS requires expedited payment processes and real-time tracking systems for claims. Significant upgrades to infrastructure are necessary to meet growing demands, and the referral system must be simplified to ensure timely access to specialized care. Increased awareness of benefits and procedures would empower veterans to better utilize available services. Additionally, incentivizing quality hospitals for empanelment and selecting specialist doctors with care could enhance the overall standard of healthcare.
The ECHS was envisioned as a well-structured scheme to provide the latest and best healthcare to veterans. While it has made some strides, many systemic and logistical challenges remain unaddressed. Both empanelled and service hospitals must ensure that veterans are treated with the dignity they deserve.
One pressing issue that requires immediate attention is the communication process for veterans drawing monthly medications. Allowing prescribed regular medications for two months instead of the current one-month system could alleviate crowding at ECHS facilities and reduce the costs and discomfort associated with monthly visits. This change could streamline procurement and inventory management.
Additionally, the government often instructs veterans to purchase necessary equipment upfront, with reimbursement promised later. This approach fails to consider the financial burden on ex-servicemen, particularly those who may struggle to make initial payments for costly apparatus.
Many veterans also face mobility challenges due to various health issues, highlighting the need for a proper transport system to facilitate movement for senior citizens and reduce parking difficulties. In cases of acute immobility, the availability of ambulances, possibly on a cost basis, would be beneficial. Regular awareness campaigns for ECHS patients could enhance understanding of the rules, regulations, and any changes to the system.
As the ECHS continues to evolve, addressing these multifaceted challenges will be crucial to ensuring that veterans receive the quality healthcare they were promised and deserve.
Source: Original article