Kolkata: Within one and a half months of Ayushman Bharat PM-JAY (ABPMJAY) roll-out in Bengal, pacemaker surgery under the health scheme has hit a roadblock, with most private hospitals asking for a revised rate for the device and procedure.Cardiologists across various private hospitals in Kolkata have approached the state health department as well as the health ministry, seeking a rate revision under Ayushman Bharat to make the pacemaker surgery package practical and at the same time, ensure quality treatment. An appeal, signed by 50-odd cardiologists from private hospitals, detailed the reasons for the need of raising the device rate allowed under Ayushman Bharat.A hospital official pointed out that under the central health ministry scheme, the cost of a pacemaker was capped at Rs 75,000 and that of the procedure Rs 33,000. This rate, the official said, was way less than what was offered by Swasthya Sathi, the health scheme launched by the earlier Trinamool govt and was now being phased out. Under Swasthya Sathi, the package allowed to private hospitals was Rs 1.6 lakh for a pacemaker and Rs 30,000 for the implant procedure.“The Swasthya Sathi package allowed us to use an imported pacemaker, which was of standard quality. Now, no vendor is willing to supply such a pacemaker at the cost offered under Ayushman Bharat. Therefore, we are left with no other option but to either compromise on the device quality or refuse to carry out the procedure under the central health scheme,” said a cardiologist.Another hospital official said under Ayushman Bharat, the cost of a pacemaker had remained the same at Rs 75,000 since the central health scheme was launched in 2018, when 1 USD was equal to around Rs 60. But despite the depreciation of the Indian Rupee, which was now above Rs 96 against 1 USD, the rate allowed for a pacemaker under Ayushman Bharat was still the same.Most pacemakers used in India are imported from Europe or the US. A majority of doctors TOI spoke to said while stents made in India were of a standard quality, there had been safety and quality concerns regarding pacemakers manufactured here. Despite their objections to the low package rates under Swasthya Sathi, cardiac pacemaker procedures were regularly conducted at private hospitals under the earlier health scheme as the device cost under it allowed them to use quality devices, a cardiologist said.Pointing at the importance of easy availability of good pacemakers, interventional cardiologist P K Hazra said the general population of Bengal were at 10% higher risk of developing heart blockage. “Cardiac pacemaker is a life-saving device and we must ensure it is of standard quality, giving the maximum benefit without safety concerns. We should not be compromising on its quality,” said Hazra who recently launched Sanatani Swasthya Sena, an organisation of healthcare providers.
