India, which is ambitious in committing itself in to a Universal National Health Protection Scheme (NHPS), should at first need to regulate its health insurance sector. Discuss (200 words)
Refer – The Hindu
Enrich the answer from other sources, if the question demands.
IAS Parliament 6 years
KEY POINTS
NHPS
· National Health Protection Scheme (NHPS) (Ayushman Bharat) is a proposed scheme of GoI, announced in Union Budget, 2018-19.
· It is dubbed to be the world’s largest government funded healthcare programme.
· The scheme seeks to provide health cover to 10 crore economically vulnerable families.
· Every family will be provided Rs. 5 lakhs annually for secondary and tertiary health care.
Issues in Health Insurance sector
· Insurance policies sold to individuals invariably contain a plethora of exclusions in the fine print, which diminishing their practical value.
· By its very nature, such exclusion defeats the purpose of the health policy and tilts the balance heavily in favour of the insurer firms.
· The health-care system also lacks regulation of costs.
· Also, there is an asymmetry of information, with the insured member unable to assess the real scope of the policy or negotiate the terms with the provider.
· These highlight the need for stronger regulations within the health insurance and hospital sectors in India.
Way forward
· Delhi HC’s observations in this regard, exclusions cannot be unreasonable or based on a broad parameter such as genetic disposition or heritage should have a broader effect of eliminating similar exclusions.
· The central government in line with the Delhi HC, must review all the policies, and eliminate unreasonable exclusionary clauses designed to avoid claims.
· Also, there is a necessity to define costs, curb frauds and empower patients.
· Insurance law has to be revisited to ensure that there is a guaranteed renewal of policies, and that age is no bar for entry.
· It needs to be ensured that pre-existing conditions are uniformly covered.
· State sponsored insurance that is universal in coverage (which is envisioned in the long-term) could help in addressing the problems of exclusion.
· As a short-term priority, it is important to remove discriminatory clauses in policies and expand coverage to as many people as possible.
pradeep kumar BEHARA 6 years
plz review
IAS Parliament 6 years
It would be better if issues such as exclusions, cost regulations and information asymmetry could have been discussed. Keep writing.
kaur 6 years
