Any Medical Insurance Scheme Should Be Over and Above CGHS: C. Srikumar

OPINION PIECE

A strong wave of concern has gripped Central Government employees and pensioners after reports emerged that the Government is considering abolishing the Central Government Health Scheme (CGHS) and replacing it with a medical insurance scheme.

C. Srikumar, Veteran Trade Union Leader, General Secretary of AIDEF, and Standing Committee Member of the National Council JCM, clarified that they strongly oppose the move and said: Any Medical Insurance Scheme should be over and above CGHS benefits. CGHS is a time-tested healthcare scheme. Shortcomings should be rectified, not destroyed.”

CGHS: A Time-Tested Healthcare Model

The CGHS, introduced in 1954, is a contributory scheme aimed at providing comprehensive healthcare to Central Government employees, pensioners, Members of Parliament, former Presidents and Vice Presidents, ex-judges of High Courts and the Supreme Court, and even freedom fighters.

Currently, CGHS has:

• More than 2,500 empanelled private hospitals and diagnostic centres

• Over 5,500 Wellness Centres across India

• Major Shortcomings in CGHS Highlighted by Srikumar

• While defending CGHS, Srikumar admitted there are pressing issues that need urgent attention:

• Shortage of doctors, nurses, and paramedical staff

• Non-inclusion of many modern treatments and diagnostic procedures

• Outdated treatment rates, forcing hospitals to opt out

• Delay in payments to empanelled hospitals and diagnostic centres

• Shortage of medicines in CGHS wellness centres

• Denial of specialised medicines under the generic drug policy

• Overcharging by empanelled hospitals beyond prescribed rates

• Non-implementation of Parliamentary Standing Committee recommendation to establish CGHS centres in every district

• Very limited empanelment of AYUSH-based hospitals

Insurance Cannot Replace CGHS

On the proposed medical insurance scheme, Srikumar warned:

• Outpatient treatment is not covered

• High premium rates, especially for senior citizens

• Restrictive coverage and limited network hospitals

• Complex claim processes

• Increased dependence on private insurance companies

“Why should Central Government employees and pensioners be left at the mercy of insurance companies?” he asked.

Call for Strengthening CGHS

Srikumar concluded by urging the Government to:

• Strengthen and expand CGHS instead of abolishing it

• Implement the Parliamentary Standing Committee’s recommendations

• If insurance is introduced, it should be in addition to CGHS, with the Government bearing the premium

He reiterated that any attempt to abolish CGHS will face strong opposition from employees and pensioners.

Views expressed here are those of C. Srikumar, a veteran Trade Unionist, General Secretary of AIDEF, and Standing Committee Member of the National Council JCM