Chennai: Tamil Nadu is opening paid wards in government hospitals for patients without govt insurance at rates set under the state’s health insurance scheme. The move, officials say, seeks to bridge a stark divide: private hospital bills can strain household finances, while public hospitals remain affordable.Pay wards in 24 hospitals, including medical college hospitals, have vacancy rates of 30% to 50%, according to officials. Tamil Nadu Health System Project director Dr S Uma said most patients currently admitted to these wards were covered by the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) or the New Health Insurance Scheme (NHIS) for government employees and pensioners. “Most patients admitted there are those with state health insurance or government employees’ health insurance. We have now defined the protocols to admit patients without these schemes,” she said.An Oct 7 letter from the project allows pay wards to accommodate patients covered by applicable insurance schemes and eligible new health insurance scheme beneficiaries, alongside those paying for themselves. Hospitals have been directed to follow treatment and surgery charges prescribed in a Sep 2021 government order and applicable CMCHIS package rates. “Patients willing to get admitted in these wards will have to make payments for the entire package,” Uma said.The National Statistical Office’s 80th round, which ran from January to December 2025, shows a stark difference in treatment cost. For instance, Tamil Nadu, families spent an average of Rs 69,914 out of pocket per delivery in a private hospital, compared with Rs 1,412 in a government hospital. Average out-of-pocket medical spending per hospitalisation, excluding childbirth, was ₹1,357 in government hospitals, compared with ₹74,168 in private hospitals.All pay ward revenue must be deposited in a separate account maintained by the head of the institution. It must first meet operating expenses, including staffing, consumables, utilities, housekeeping and maintenance. Any surplus may support hospital development, equipment and medicines under prescribed financial procedures, the letter said.Doctors said lack of information at hospital receptions meant patients were not routinely offered a choice between a general ward and a pay ward. At Omandurar Multi Speciality Hospital, director Dr V V Kannan said nearly half its pay ward rooms were vacant despite facilities that could support step-down intensive care. “They ask us if we can offer them free treatment if they pay just room rent. It doesn’t work that way anymore,” he said. “The wards are new and clean and match facilities at private hospitals at less than half the cost. People haven’t been taking them because they are not aware of the schemes we offer.”Deans have recommended that the state also accept private and corporate health insurance. A former medical college dean said expanding the service would require investment in hospitality as well as clinical care. A public-private partnership could help provide services such as patient relations staff, wider food choices and assistance beyond bedside treatment, he said.“We are experts in healthcare, but we need assistance in hospitality,” he said. “We must make it attractive for people to come,” he said.
