NEW DELHI: An ailing economy and an emerging destination for medical tourism, India has just made it easier for its bureaucrats and their immediate family members to fly abroad for treatment at the government’s expense.The Centre has decided to reimburse the total cost of treatment abroad as well as fund the return airfare for IAS, IPS and IFS officers, changing the 30-year-old rules at a time the government is facing flak for the country’s worrisome fiscal health just months ahead of the general elections.In a vigorous modification to the 1983 rules that some critics have derided as something of a killer overdose in an economy that needs urgent belt-tightening, the Department of Personnel and Training (DoPT) has informed the chief secretaries of all states on September 2 through a letter, a copy of which has been accessed by ET, that the government will bear the actual cost of treatment abroad for two months.The previous rules did not include airfare, and the government reimbursed the medical expenditure only to the extent the same treatment would cost in a private ward at the All India Institute of Medical Sciences (AIIMS) in New Delhi.As per the revised rules, the government will reimburse airfare not only for the bureaucrat but also one accompanying attendant subject to a decision by a committee of bureaucrats to be set up at the state and central levels.The entitlement for the airfare as well as the medical treatment will now be the same as that of an IFS officer of the corresponding grade stationed abroad.“Given the high entitlement of an IFS officer overseas, every bureaucrat can easily claim the actual medical expenses abroad. Government officers were facing a lot of financial hardship due to the earlier rules,” said a DoPT official, who did not wish to be named, describing the modifications as “progressive” while admitting that the new rules might end up burning a hole in the government’s pocket given the high cost of medical treatment abroad.Officers are entitled to free medical treatment for self and immediate family members in all government hospitals and some private hospitals across India.Former cabinet secretary TSR Subramanian said the new provisions had high potential for abuse and pointed out that many patients from abroad, including the US, were coming to India for medical treatment. “I fear even routine cases of bypass surgery for bureaucrats will now end up abroad,” Subramanian told ET, adding, “I have my sympathies with the genuine cases, but harsh as it may seem, I think this is an impractical decision.There is rarely a disease for which treatment is not available in India and the cost for the same treatment in the US or Europe is far higher.”The DoPT official pointed out that even under the revised rules, the government would reimburse the cost of medical treatment abroad only for cases where treatments were not available in India. However, the list of diseases specified by the government for treatment abroad has been expanded in the new guidelines.The earlier rules specified that only a kidney transplant, second heart bypass operation, bone marrow transplant, operative correction for high myopia and heart ailment for infants would qualify for treatment abroad. But as per the new rules, treatment of any ‘extremely complex ailment’ will be eligible if, in the opinion of a central committee constituted in the health ministry, it can only be treated abroad and falls in the ‘high-risk’ category.The other ailments eligible for treatment abroad, according to the new guidelines, include “complex/ high risk cardio vascular surgery, bone marrow transplant, complex medical and oncological disorders such as leukemia and neo-plastic conditions and complex high-risk cases in micro vascular and neuro surgery”.The new rules specify that the officers seeking permission for treatment abroad need to send their medical history to the committee along with the certificates of a specialist recommending the treatment abroad as well as acceptance of the case by the hospital abroad where the treatment is proposed to be availed of. The guidelines have also allowed reimbursement of airfare for the officer and one attendant in case of domestic travel for treatment.