Made Gowda, 53, a farmer from Mandya district near Bangalore, recently underwent a heart operation in Narayana Hrudayalaya, the city's largest heart hospital. Nothing unusual about the whole thing except for the fact that he paid virtually nothing for the surgery that normally costs between Rs 1.2 lakh and Rs 1.4 lakh. For the cost of a coffee in an upscale coffee bar, farmers and their families undergo different types of operations, including those of the stomach, gall bladder, uterus, eyes, heart and brain, free of cost.

"The good thing about this scheme is that things are not as complicated as they are in an insurance firm."

RAMA SWAMY 49 Swamy, a farmer, had an operation performed upon his heart to remove two arterial blocks.

Gowda is one of 17 lakh farmers who paid just Rs 5 every month under a cooperative sector scheme that allows them to have similar operations. His was one of the 6,000 surgeries carried out at the 780-bed Narayana Hrudayalaya under the Yeshasvini health scheme launched in the cooperative sector by the Government in June last year, basing it on an idea thought of by Narayana Hrudayalaya's founder and heart surgeon Devi Shetty. The members of the cooperatives involved in this scheme, mainly poor farmers, pay just Rs 60 per annum. In return, they can avail of the best healthcare in the state. Says Shetty: "We cannot become a developed nation unless healthcare is made available to all strata in society." He adds, "We found the problem was not the infrastructure but the inability to pay for healthcare which was the real malaise."

And that was how he struck upon the Yeshasvini scheme that would, in the first phase, make modern healthcare available for free to 17 lakh farmers and their family. The scheme works because studies have shown that on average only 0.08 per cent of the people covered would require operations. This means the cost of their treatment is borne through the contribution of the others who do not need medical help. It is this concept that came to the rescue of farmers like Gowda and Jayamma from Anekal village in Bangalore who underwent hysterectomy-removal of the diseased uterus-for free. They could never have otherwise afforded the normal costs of the operations that are usually in the range of Rs 15,000-20,000.

"Had I not been a member of this scheme, I can't imagine what my fate would have been."

IMRAN AHMED 19 A milkboy, Ahmed too underwent a major open-heart surgery after blocks were detected in two of his heart valves.

It all began when the Karnataka Milk Federation (KMF), a cooperative with more than two million members in Bangalore, invited Shetty. He had been asked to endorse a milk product but he took the opportunity to convince the kmf managing director to extend health benefits to all its members by paying a nominal Rs 5 a month. It was at the same function that the surgeon got the opportunity to suggest this revolutionary health plan to Chief Minister S.M. Krishna. Krishna, in turn, introduced Shetty to A. Ramaswamy, principal secretary in the department of cooperatives. So was born the Yeshasvini scheme with KMF members as its first beneficiaries.

Ramaswamy, who named the scheme Yeshasvini (victor, in Sanskrit), says that in the scheme a major chunk of the budget allocated for healthcare in a family goes to the earning male member, followed by children and women. The scheme, however, does not cover a married member's parents. It is now extended to most cooperative units in the state. And, it is supported by 83 hospitals across Karnataka which are paid by the scheme trust for the members' treatment. Maharashtra and Tamil Nadu Governments are in dialogue with the trust to include cooperatives in their states in this ambitious scheme. Shetty dreams of expanding Yeshasvini throughout the country.

"Doctors don't make you feel afraid at all."

R. KUMAR 10 Son of a farmer, he is happy about the operation performed upon his heart.

Enthused by the initial success of the Yeshasvini health programme for farmers, the state Government decided to create a corpus of Rs 100 crore in January this year with contributions from its coffers, profitable cooperative institutions, MNCs and other donors. State Cooperatives Minister H. Vishwanath says that his target is to cover five million people. "Smart cards are being issued to those covered under this health plan. Farmers and farm workers can avail of medical benefits in the areas of cardiology, urology, gynaecology, orthopaedics, hernia and other general procedures," he adds.

Prema, a farm worker from Mandya, who was treated for a broken leg, says, "The treatment came at the right time for absolutely no cost at all." Chikkayya, a farmer who underwent a surgery for a debilitating backbone disorder, says, "The money I paid every month was half the price of a bidi packet. Now not only have I stopped smoking bidis, I am happy too."

For those like Prasanna, 21, from Tumkur district who had an open-heart surgery and valve replacement, the scheme is good news with a touch of sadness. "My father would have been living today if this scheme had been in effect, say, three years ago," he says.

The Yeshasvini scheme has attracted global attention with two major US bodies, Harvard and the Rockefeller Foundation, planning to study it closely and replicate it elsewhere, especially in African countries. The World Bank too has shown interest in the functioning of this health programme with the intention of finding more pragmatic solutions to low-cost, high-quality healthcare in the developing world.

It is good healthcare at affordable prices that matters most to Shetty. He dreamt big, but the rewards too have been big.