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LATEST NEWS UPDATES | Grim diagnosis of govt health cover -GS Mudur

Grim diagnosis of govt health cover -GS Mudur

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published Published on Feb 6, 2017   modified Modified on Feb 6, 2017
-The Telegraph

New Delhi: India's government-funded health insurance schemes have increased patients' access to hospitalisation but failed to reduce their households' personal out-of-pocket healthcare expenses, the most comprehensive review of the schemes so far has found.

The review by public health analysts has found increases ranging from 12 per cent to 244 per cent in hospital-based services across the country since the schemes were launched a decade ago. But there is no robust evidence to show that they are protecting patients' households from financial risks of healthcare costs, the analysts said.

The Centre and several state governments have cumulatively spent over Rs 37,000 crore since 2007 on the Rashtriya Swasthya Bima Yojana (RSBY) that pays up to Rs 30,000 each year in hospitalisation costs for each covered household.

The RSBY - which covers 41 million households and other state-funded schemes, some of which pay higher hospitalisation amounts - accounts for nearly 14 per cent of the 15 per cent of India's population protected by health insurance.

The new review amplifies suspicions among health experts that the schemes are not financially protecting households either because their payment caps are too low and do not cover many hospital-based services or because nearly 70 per cent of healthcare expenditure does not require hospitalisation.

"We don't see any substantial gains from this model of healthcare delivery where governments pay for health insurance," said Shankar Prinja, associate professor of health economics at the Postgraduate Institute of Medical Education and Research, Chandigarh, who led the review.

Prinja and his colleagues analysed the pooled results of 43 independent studies from across India since 2010 to evaluate the effectiveness of the insurance schemes amid concerns that over 60 million people across India are pushed into poverty every year because of healthcare expenses.

Households have used the RSBY or the state-funded schemes to seek treatment for cardiovascular, gastrointestinal, gynaecological, kidney, and ophthalmic illnesses and cancers, among other health disorders. But the treatments for many disorders may cost more than RSBY's cap of Rs 30,000 or the caps imposed by state-funded schemes.

"The Rs 30,000 may evaporate in two days, and the patients' families have to pay for the rest of the treatment and stay," said Kappoori Gopakumar, a lawyer with the Third World Network, a policy analysis and research and advocacy organisation tracking healthcare issues. Gopakumar was not involved in the review.

Nine among a set of 13 studies reviewed by Prinja and his colleagues showed no reduction in out-of-pocket healthcare expenses among households enrolled in the insurance schemes. Five of seven studies found an increase in out-of-pocket expenses.

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The Telegraph, 6 February, 2017, https://www.telegraphindia.com/1170206/jsp/frontpage/story_134295.jsp#.WJiifDideyB


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