A crown of Noors

But Dr Shetty is much more than a heart surgeon par excellence — his passion for providing affordable healthcare extends far beyond the confines of his state-of-the-art charitable institute. Thanks to his initiative, Karnataka today boasts a unique healthcare programme, the Yeshwasvini Health Scheme, under which the rural poor of the State receive the best of treatment. This includes big-ticket operations of the stomach, gall bladder, bones, eyes, uterus, brain and heart for as little as Rs 5 per month.

There is nothing ponderous about Dr Shetty. His boyish charm hides his years and gives a certain zing to his infectious effervescence. Just as his Telemedicine Programme and his heart hospitals in Kolkata and Bangalore, the Yeshwasvini Health Scheme stems from one fundamental idea — ‘‘if a solution is not affordable, it is no solution at all’’.

It was this belief that led him to rethink the whole question of healthcare for the poor. Most experts believe that one of the main reasons for suffering in rural India is the lack of good hospitals, qualified doctors and medical equipment.

‘‘What we found was that Karnataka had a big network of medical schools and hospitals but the occupancy of hospital beds was just about 35 per cent. The problem was not lack of hospitals; most villagers simply did not have money for operations,’’ says Dr Shetty.

They also discovered that ‘‘the second or third most common cause of rural indebtedness’’ was healthcare. ‘‘If a farmer has to borrow Rs 10,000 for a cataract operation or for his wife’s hysterectomy, he goes below the poverty line and never comes above that again.’’

The solution, then, lay in working out an insurance scheme that covered large numbers of people at a very nominal rate, and using Karnataka’s extensive cooperative system as the backbone. To get a Yeshwasvini Insurance Card, the person has to be a member of a pre-existing cooperative society or association. This criterion, Dr Shetty explains, was crucial for the success of the scheme, for otherwise only people with diseases would become members.

The second requirement was large numbers. Like any mediclaim scheme, it worked round the premise that only a fraction of those who get themselves insured actually go in for operations. And larger the subscriber base, the more cost-effective the scheme.

It was conceptualised by Narayana Hrudalaya in association with various cooperative societies and the Karnataka government, and to be managed by the Family Health Plan as Third Party Administrator.

The scheme was launched on June 1, 2003, with 17 lakh members across 27 districts of Karnataka. A network of 85 recognised hospitals across the State are part of it, and can conduct around 1,700 different type of operations.

For every Rs 5, the government gives Rs 2.50, and the total works out to Rs 90 per year per head.

Before the launch of the scheme, the monthly premium was collected for the whole year and deposited — otherwise, the logistics of collecting monthly payments would be more than the actual cost of premium.

In the nine months since its launch, 27,000 people have received free medical consultation and over 7,000 operations have been conducted. The success has had a ripple effect — the Maharashtra Government too has approached Dr Shetty to launch a similar scheme.

For Dr Shetty, it is only a beginning: ‘‘I want every man, woman and child in the country to have a card that can entitle them to healthcare with dignity.’’

That is a tall order, but then his favourite quote is: ‘‘Never doubt that a small group of committed people can change the world. Indeed, it’s the only thing that has.’’