In a significant ruling aimed at reforming healthcare access for government servants, the Karnataka High Court has instructed the central government to seriously consider establishing a cashless medical treatment system under the Central Government Health Scheme (CGHS). This directive specifically targets emergency and critical care situations to shield employees from financial distress.
A Petition That Highlighted Systemic Flaws
The court's order came while adjudicating a petition filed by Ivy Miller Chahal, a retired Indian Administrative Service (IAS) officer of the Madhya Pradesh cadre residing in Bengaluru. Chahal had approached the court following persistent failures to get reimbursement for her husband's substantial medical bills.
Her husband, Gurmail Singh Chahal, a retired executive director of the Madhya Pradesh Tourism Development Corporation, required emergency cardiac care. He underwent treatment at Bengaluru's Narayana Institute of Cardiac Sciences in April 2023. Later, in October 2023, he received a CRT-D (cardiac resynchronisation therapy with defibrillator) implant. The total cost of the procedure and implant amounted to Rs 15,30,093. Tragically, Gurmail Singh passed away on March 18, 2024.
Court's Stern Directions and Timely Relief
Justice Suraj Govindaraj, presiding over the case, issued clear commands. The court directed the concerned authorities to fully reimburse the Rs 15.3 lakh to the petitioner within 30 days. Additionally, the reimbursement must carry an interest of 12% per annum starting from October 30, 2023, the date when the payment was originally made.
Beyond providing immediate relief to the petitioner, Justice Govindaraj delved into the core issue plaguing the CGHS. He emphasized that the existing reimbursement model is fundamentally at odds with the realities of medical emergencies.
Why the Current System Fails in Emergencies
The judge made several critical observations:
- Emergency treatment does not allow for financial planning or prior approvals. Patients and families are forced to arrange large sums at short notice.
- Expecting individuals to navigate complex reimbursement procedures after a life-threatening event causes avoidable distress, can delay treatment, and often leads to litigation.
- This situation is especially unfair to retired employees who have limited earning capacity and financial security.
- A welfare scheme like CGHS cannot be administered with "rigid, post-event technical evaluation divorced from compassion, fairness, and common sense."
The Path Forward: Cashless Treatment as a Right
The court underscored that the necessity to mobilize funds upfront defeats the very purpose of a welfare health scheme. Justice Govindaraj stated that a robust cashless treatment mechanism, particularly for emergencies, would:
- Give meaningful effect to the right to health under Article 21 of the Constitution.
- Ensure non-arbitrary access to medical care under Article 14 (Right to Equality).
- Reinforce the state's obligation as a responsible and welfare-oriented employer.
By directing the central government to examine the feasibility of such a system, the Karnataka High Court has initiated a potential paradigm shift in how healthcare is delivered to millions of serving and retired central government employees and their families across India.
