Monday, May 11, 2009

ECHS is a Dud ...: Revisted

Thu, May 08, 2008

New Delhi: With the Sixth Pay Commission grouse still fresh, here is another grim reminder of the an initiative meant for the welfare of ex-servicemen virtually on the brink of a collapse.

Meet Col Jitendar Singh. He served the country with pride for decades, wearing his beloved olive greens, secure in the belief that he would be taken care of in his older days. But today, the critically ill Colonel is among India's two million ex-servicemen and their families have nowhere to go. With the ambitious Ex-Servicemen Contributory Health Scheme on the brink of collapse, their only hope is shattered.

“Gangrene had not set in then. It set after the delay from Apollo hospital’s end. And when we said we are ECHS members, they said we are now cut off from ECHS,” he said.

The reason for his agony is that leading hospitals have pulled out of the ECHS because of enormous outstanding payments. “Bills take ages to get cleared. This scheme will die its natural death,” says VP Operations, Fortis Hospital, Jasbir Grewal.

The Army itself admits that the health scheme needs life support. It acknowledges that routine bills take two to three months for clearance. Bills over Rs 5 lakh require Defence Ministry’s approval, which takes a minimum of 6 months. Only six lakh out of 20 lakh ex-servicemen have enlisted reflecting lack of confidence in the scheme.

The abysmally low payment rates of Central Government Health Scheme to which the scheme is tied rule out quality medical care. “Hospitals have always been loathe to accept these rates. I can’t understand why army cant have its own rates,” says former MD, ECHS, Maj. Gen. Kuldip Sindhu.

It's a "crying emergency" situation for ECHS. After 5 years of completion it was expected of the scheme to have over come the difficulties in its implementation but the disharmony between the hands holding the scheme together has only become more conspicuous over these years.

Special: Govt health scheme for ex-servicemen a dud

Comment: Has ECHS moved forward resolving the teething problems in the last one year? Certainly a big "NO". In fact the constraints are growing greater and efficiency and ESM satisfaction on rapid downslide. ECHS will ulitimately collapse under its own bureaucratic hurdles and cobweb of rules and regulations. The Polyclinic's notice boards are filled with chunk of Letters in English which is hardly read by any sane ESM and those not conversant with English are saved the agony of understanding them!


  1. The ECHS is a non-starter . It is not a user-friendly scheme but a highly bureaucratic one ; and the user here is a poor widow of a jawan living in a village and not a high ranking officer living at Delhi , Pune etc . The ECHS in its present avtar fails the test in this context . The procedure and processes involved are too much for a user described above ; not to talk of the problem of bill payment/clearance , which i feel is because of the fact that the scheme is basically designed on the lines of CGHS and similar rates of payment/clearance are applicable . The incident quoted above supports me .
    My brother-in-law is a retired person from ONGC . Both he and my sister have many medical problems for last 4/5 years . They go to Hinduja and Lilavati frequently for their treatment but have faced no admin or procedural problems till date ; possibly because their scheme is not designed as a bureaucratic one .
    I feel that in case BJP comes to power and they mean what is promised in their manifesto ECHS must be core issue besides OROP which IESM must take up with them for which a number of ex-service persons shall bless you .
    In the meanwhile I feel IESM should appoint a core group to study the problem from the perspective of the last person in the chain - the poor widow of a jawan living in a village and design a user friendly scheme , which then is presented to the Govt .
    Even if BJP does not come to power lets not lose heart IESM has emerged as a force to reckon with and the next round of election may not be far off .

  2. ECHS was created solely to reduce the load on service hosp and to offer qual health care to ESM.Referral system is so complex and irritat-ing that a rural based less educated ESM and his dependants escorting/carrying a patient to metro empanelled hosp has to run from pillar to post, shuttling between poly clinic and local service hosp at home station and then between regional ECHS and service hosp at the destination loses his faith and confi-dence in inherent service bureaucracy.Why can't we have a system that a referral from home station suffices and patients can direct-ly report to empanelled hosp without being tossed around at the destination station ? Why are the service hosp playing the role of "a dog in the manger policy"??