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LATEST NEWS UPDATES | Covered by govt health insurance, still paying hospital bills -GS Mudur

Covered by govt health insurance, still paying hospital bills -GS Mudur

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published Published on Nov 23, 2017   modified Modified on Nov 23, 2017
-The Telegraph

New Delhi: Most households covered by government-funded health insurance have to use personal funds to pay for hospitalisation, a study has suggested, iterating concerns about the wisdom of deploying public-funded insurance schemes to seek universal health coverage in India.

The study, designed to determine how well government-funded health insurance protects households from health expenditure, has found that 66 per cent of such households who sought healthcare in public hospitals and 95 per cent that turned to private hospitals had to pay for treatment.

Health researchers say the findings question the effectiveness of government-financed health insurance schemes at a time the government has signalled its intention to reinforce its dependence on them.

The national health policy 2017 announced by the Narendra Modi government earlier this year seeks to scale up and strengthen government-funded health insurance schemes to purchase services from public, non-for-profit and private sector in that order or preference.

The Centre's Rashtriya Swasthya Bima Yojana and similar state-funded health insurance schemes cover over 200 million people, while private insurance plans take the total number of insured people in India to about 360 million - about 30 per cent of the population.

These schemes typically pay from Rs 30,000 to Rs 100,000 for certain hospital-based services.

The new study analysed health spending for hospitalisation by insured households in Chhattisgarh - a state which has one of the highest enrolment population rates in government-financed health insurance.

"Chhattisgarh presents a test case for the whole of India," said Sulakshana Nandi, a researcher with the Public Health Resource Network, a non-government entity, who led the study, collaborating with the University of Western Cape South Africa and the Tata Institute of Social Sciences,Mumbai.

"Our findings should prompt a re-examination of plans to expand government financed health insurance," she said.

Households covered by the scheme in Chhattisgarh should in principle have received fully cashless services for specified conditions that require hospital treatment in any of 753 empanelled hospitals, including 462 private hospitals.

But Nandi and her colleagues observed that 34 percent hospitalisation episodes in public hospitals and only five per cent in private hospitals were cashless services. They have published their findings in the journal PLOS One.

Please click here to read more.


The Telegraph, 23 November, 2017, https://www.telegraphindia.com/india/covered-by-govt-health-insurance-still-paying-hospital-bills-188208


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