{"id":31492,"date":"2018-10-27T14:22:38","date_gmt":"2018-10-27T08:52:38","guid":{"rendered":"https:\/\/blog.forumias.com\/?p=31492"},"modified":"2018-10-27T14:22:38","modified_gmt":"2018-10-27T08:52:38","slug":"making-health-insurance-work","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/making-health-insurance-work\/","title":{"rendered":"Making health insurance work\u00a0"},"content":{"rendered":"<p><a href=\"http:\/\/www.thehindu.com\/opinion\/op-ed\/making-health-insurance-work\/article22661666.ece\"><b>Making health insurance work<\/b><\/a><b>\u00a0<\/b><\/p>\n<p><strong>Context:<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The National Health Protection Scheme is disconnected from primary care.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The previous government failed to implement the recommendations of the High-Level Expert Group on Universal Health Coverage (2011).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The Union Budget 2018 resonate those recommendations with commitment to universal health coverage which includes:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">1-<\/span><span style=\"font-weight: 400;\"> \u00a0\u00a0\u00a0\u00a0\u00a0<\/span><span style=\"font-weight: 400;\">\u00a0Strengthening of primary health care, linking new medical colleges to upgraded district hospitals,<\/span><\/p>\n<p><span style=\"font-weight: 400;\">2-<\/span><span style=\"font-weight: 400;\"> \u00a0\u00a0\u00a0\u00a0\u00a0<\/span><span style=\"font-weight: 400;\">\u00a0Provision of free drugs and diagnostics at public health facilities.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">3-<\/span><span style=\"font-weight: 400;\"> \u00a0\u00a0\u00a0\u00a0\u00a0<\/span><span style=\"font-weight: 400;\">\u00a0Stepping up financial protection for health care through a government-funded programmed that merges Central and State health insurance schemes.<\/span><\/p>\n<p><b>About NHPS:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\"> \u00a0\u00a0<\/span><span style=\"font-weight: 400;\">The scheme will provide cost coverage, up to <\/span><span style=\"font-weight: 400;\">\u20b9<\/span><span style=\"font-weight: 400;\">5 lakh annually, to a poor family for hospitalisation in an empanelled public or private hospital.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The precursor of the National Health Protection Scheme (NHPS), <\/span><span style=\"font-weight: 400;\">the Rashtriya Swasthya Bima Yojana (RSBY),<\/span><span style=\"font-weight: 400;\"> provided limited coverage of only <\/span><span style=\"font-weight: 400;\">\u20b9<\/span><span style=\"font-weight: 400;\">30,000, usually for secondary care.<\/span><\/li>\n<\/ul>\n<p><b>Loopholes:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Though it improved access to health care, it did not reduce out-of-pocket expenditure (OOPE), catastrophic health expenditure or health payment-induced poverty.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The NHPS addresses those concerns by sharply raising the coverage cap, but shares with the RSBY the weakness of not covering outpatient care which accounts for the largest fraction of OOPE.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The NHPS too remains disconnected from primary care.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The NHPS will pay for the hospitalisation costs of its beneficiaries through \u2018strategic purchasing\u2019 from public and private hospitals.<\/span><\/li>\n<\/ul>\n<p><b>Way ahead:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Well-defined list of conditions that will be covered, adoption of standard clinical guidelines for diagnostic tests and treatments suitable for different disorders, setting and monitoring of cost and quality standards, and measuring health outcomes and cost-effectiveness.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Both Central and State health agencies or their intermediaries will have to develop the capacity for competent purchasing of services from a diverse group of providers.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The choice of whether to administer NHPS through a trust or an insurance company will be left to individual States.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\"> \u00a0\u00a0<\/span><span style=\"font-weight: 400;\">Strengthening primary health services and public hospitals.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Making health insurance work\u00a0 Context: The National Health Protection Scheme is disconnected from primary care. The previous government failed to implement the recommendations of the High-Level Expert Group on Universal Health Coverage (2011). The Union Budget 2018 resonate those recommendations with commitment to universal health coverage which includes: 1- \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Strengthening of primary health care, linking&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/making-health-insurance-work\/\">Continue reading <span class=\"screen-reader-text\">Making health insurance work\u00a0<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[555],"tags":[],"class_list":["post-31492","post","type-post","status-publish","format-standard","hentry","category-test-1","entry"],"jetpack_featured_media_url":"","views":{"total":0,"cached_at":"","cached_date":1704700448},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/31492","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=31492"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/31492\/revisions"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=31492"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=31492"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=31492"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}