Why Healthcare in India is in a State of Crisis

Why Healthcare in India is in a State of Crisis

Why Healthcare in India is in a State of Crisis

Since the economic reforms and liberalization of 1991, India’s economy has witnessed a dizzying growth. The per capita income mirrors this trend. Thanks to the economic boom, millions of Indians have left behind them the shadow of the Below Poverty Level days and can now access quality education, food, and jobs. But this has not translated to an improvement in healthcare in India or rise in India’s Human Development Index. One of the most important yardsticks for measuring how the people of a country are faring is healthcare services. Even though India is making strident progress in medical science, the fruits of it remain beyond the reach of a large chunk of the population because health care is expensive.

What do the statistics say?

The National Health Profile in 2018 surveyed the actual percentage of GDP; different countries spend on health care. The survey found that India languishes almost at the bottom of the list. At present only 1.02% of the GDP goes into the health industry or INR 3 per person every day. The Modi government has promised to raise it to 2.5% by 2025, which still falls abysmally short of the global average allocation of 6%. The numbers are too nominal for a country like India which has a high Gross Domestic Product.

The health care allocation is so inadequate that out of pocket expenditure contributes to about 67.78% of expenses on health as compared to the world average of 18%. Among all the Indian states, Bihar allocates the least, only INR 491 per capita. On the other end of the spectrum is Mizoram, which reserves 4.2% of its GDP for medical care.

Why is the cost of medical services making people destitute?

The National Sample Survey found that in the financial year 2013-2014, 36 million families ratcheted up healthcare bills that exceeded the amount they set aside for food and other necessities, on a yearly basis. 25 million of these families are from rural India, mostly without health insurance. That is why one in five of the poorest households incur health care expenses that are catastrophic for their finances.

The Union Health Ministry discovered that 43% of India’s population directs it’s out-of-pocket expenses towards paying for medicinal care services. And that is why medicines are a burden for most families.

The cost of inadequate actions on part of the government has been disastrous. The National Crime Records Bureau revealed that between 2001 and 2015, nearly 0.39 million Indians committed suicide as they were unable to pay for healthcare. To add to the misery, the staggering costs of healthcare in India dragged 7% of the population below the poverty level.

Why didn’t the Change in pricing laws help?

Introducing major changes in pricing laws and including almost 750 medicines in the list of essentials the price of which will be capped by the government, has not really helped because many vital life-giving medicines have been left out of the pricing committee’s purview. 

What does the National Health Policy have to say?

The National Health Policy in 2017 advised lowering the price of medicines and other services further as a first step to help solve this crisis of healthcare in India. Other measures this body suggested were- increasing allocation and funding, and making supply chains more efficient.

The only solution to this grim scenario is to allocate a sizeable portion of the GDP to healthcare in India and make sure that the distribution of services is even and accessible to all across the lines of demographics.

The facts and figures speak for themselves to show that the status of Healthcare in India is truly in Shambles. You know about the numbers that back this pathetic situation that truly needs a lot of work. What are the actual challenges that are being faced in this regard? Keep reading to find out. 

Sources:

  1. Down to earth
  2. Livemint
  3. DNA India
How healthcare plans work

Revealed: How Health Insurance Plans Work

How healthcare plans work

You might have been told that purchasing a health insurance scheme is one of the best investments you will ever make. But, what exactly is it and how does it work? Simply put, healthcare policy is a legal contract between you – the insured and the insurance provider. 

And like all contracts, both parties have to adhere to certain terms and conditions. Rest assured both the insurer and the insured benefit from it. 

How do you stand to gain from a healthcare policy?

A health insurance policy offers you an impressive list of benefits-

Extensive Coverage

It covers a wide range of diseases. If you are hospitalized because of any one of them, you can register a claim and your insurance policy will take care of all the bills within your insured amount. 

Health policies cover the following: 

  • Doctors’ and nurses’ fees
  • Pre and post hospitalization costs
  • Room rent
  • Medicines
  • Diagnostic Tests
  • Surgery and prosthetic devices

Out-Patient department coverage

These days most health insurance schemes include Out Patient Department coverage. So if you come down with minor ailments, you will no longer have to pay for your treatment from out of your pocket. Insurers also do not require you to stay in a hospital for 24 hours as a prerequisite for filing a claim.

No Claim Bonus or NCB

A very useful perk a healthcare policy offers is the No Claim Bonus. If you do not make a claim on your policy for a whole year, your insurer rewards you with the NCB. You have the option of accumulating NCBs and then utilizing them for either as an increase in the sum insured or a discount on the premium.

And, if you want to switch to another insurer, you can transfer the NCBs to the new policy.

Network hospitals

All insurance companies work in tandem with reputed hospitals to bring you the benefit of cashless treatment. If you seek treatment in one of the hospitals your insurer has tied up with, you will not have to pay your bills first and then seek reimbursement later. The insurer will settle the payments directly with the hospital once your doctor discharges you.

Maternity cover

Almost all health insurance policies come with maternity benefits. It’s a boon for all young couples as it covers the expenses of running neonatal tests, ascertaining the health of both mother and baby, and vaccinations.

Tax benefits

Section 80D of the Income Tax Act exempts the sum insured from being taxed. Because the government does not consider it as a source of income.

What do you have to pay for these benefits?

Nothing comes free and this is where insurers benefit. They charge you a premium. Insures decide how much you have to pay through a process of underwriting. They do a risk analysis based on your age and medical history. If you have a clean chit, it means you are not very likely to fall gravely sick. Which means there are fewer chances of you making a claim. So, a healthy person pays the lowest quantum of premium. Note that you have to pay the premium on a regular basis or your policy could lapse.

Conversely, if you are elderly and have suffered from a number of ailments, you will have to pay a higher premium. Insurers may ask you to undergo health tests to gauge the risk factor.

If you are already suffering from an illness when you decide to purchase a policy, insurers might refuse to sell you one if they think the risk outweighs the gains.

Some other facets of healthcare policies you should know of:

Co-Pay

This is another means that insurers rely on to reduce the risk factor. Many health insurance policies require you to pay a portion of your health care costs. Your policy pays the rest. This also discourages people from making flippant claims.

TPAs

Third Party Administrators act as mediators between the insurer and the insured. They help with claim processing, disbursing payments and collecting premiums, providing ambulance services, preauthorization with network hospitals etc. TPAs are the backbone of the health insurance industry.

Exclusions

You need to peruse the list of exclusions meticulously. These are scenarios that your health insurance policy will not cover. Sometimes it could be something as vital as eye or dental check-ups. Some other exclusions include joint replacement surgeries, cosmetic procedures to enhance appearance and treatment for self-inflicted injuries. 

There is also a stipulation that states that if you are opting for non-conventional treatments like Ayurveda or homeopathy, you need to seek it from a government hospital or your policy will not cover it.

Conclusion

Health insurance policies should be an instrumental part of your budget, especially now that healthcare costs have soared and even the simplest treatments can burn a hole through your pocket.

Picking the right Health Insurance policy from the endless list of available options can be quite a tricky task especially because of the exclusions interwoven within. Which are the services not covered by your Health Insurance Policy? Read our blog on the same to find out. 

Sources:

  1. Moneycrashers
  2. Bankbazaar
  3. Policybazaar

 

What your Health Insurance Policy will not cover

What your health insurance policy will not cover?

What your Health Insurance Policy will not cover

Health insurance policies contain lots of terms and conditions and unless you go through them with a fine-tooth comb, you will miss the exclusions. If you are not aware of them, you might face claim denials or reduced payout of the sum insured. 

What are the most common health insurance exclusions?

Pre-existing Illnesses

If you are already suffering from an illness when you purchase a health insurance policy, your insurer will consider it a pre-existing illness. Most insurers do not cover pre-existing illnesses. And even if they do, you need to wait out a period of 2-4 years before you can receive the benefits of the policy. The exact waiting period depends on the type of illness. 

Some illnesses like kidney stones, arthritis, cataract, joint disorders are not considered as pre-existing illnesses.

Pregnancy

There are some policies that exclude maternity benefits like pre and postnatal care, health check-ups during pregnancy, the cost of delivering the child etc. And even when maternity benefits are included, they only kick in after 1-2 years from the date of purchase. 

Surgeries

Certain surgeries like a knee replacement, facial rejuvenation, and dental procedures are excluded in all health insurance policies.

Alternative modes of treatment

Alternative treatment methods like homoeopathy, Unani, Ayurveda are usually excluded from a health insurance policy. Some policies do cover them but only at government-sponsored hospitals.

Treatment at your home

If you opt for continuing your treatment at home, your insurance policy will not cover it.

Particular drugs

Even if a particular illness is not excluded, not all medicines needed for treating that illness may be included in your health insurance policy’s coverage. For example, chemotherapy drugs administered intravenously may be included but if they are to be administered orally, they may be excluded.

Attempted suicides

A health insurance policy will not cover the treatment of illnesses or injuries sustained during a suicide attempt.

Illnesses born out of substance abuse

If you fall gravely ill from chain-smoking, alcoholism or drugs, your health insurance policy will not come to your aid.

Fees of the resident doctor

If your resident doctor’s bill is not included with your room rent, your health insurance policy will not pay for it. Some hospitals do segregate the two and that might leave you in a tight spot. That is why it is advisable to seek treatment from network hospitals whose payment policies are aligned with that of your insurance provider.

Some other exclusions of a health insurance policy

  • Screening cost for donors
  • Treatment for psychological disorders
  • Hearing aids or contact lenses
  • Charges for bedpans, laundry or walking sticks
  • Baby food

 

Conclusion

Health insurance policies can be your best friend at a time of medical emergency but they are only as good as the exclusions they come with. That is why you need to look into the exclusions before you decide which policy you will purchase.

Picking the right Health Insurance policy from the endless list of available options can be quite a tricky task especially because of the host of exclusions interwoven within. What are exclusions that you need to look out for before settling on a Health Insurance policy? Read our blog on the same to find out. 

Sources:

MediBuddy App – Now Revamped and Updated!

MediBuddy App – Now Revamped and Updated!

MediBuddy App – Now Revamped and Updated!

You already know about the MediBuddy App – your trusted Health and Wellness mobile application. In our effort to constantly improve your user experience, we have revamped and updated the entire application and have also incorporated a host of new features curated meticulously with you – the user, in mind. This update will give you both – an absolutely seamless browsing experience and access to our latest healthcare monitoring features, which you can use to effectively manage and track the daily status of your health.

Here’s what’s new:

  • State of the art Health Tracker: Right on the home screen as soon as you login with your registered credentials, you will be able to see our latest Health Tracker in a running tile format. With this feature you can track your Daily Water Consumption, Steps Taken, Calories Burnt, Body Weight and Blood Pressure Fluctuation. The tracker is integrated with Google Fit as well!
  • Offers Widget: Below the Health Tracker, you have a personalized Offers Widget which will regularly display the latest offers and current discounts that you can avail on our range of offerings. The widget displays exclusive recommendations based on your previous usage history and choices.
  • Reminders Setting: We know how hectic your lifestyle can get. With that in mind, we have designed a Reminders feature which you can use to remind you at set intervals to consume food, stay hydrated, go for a workout, take a power walk and regularly record your weight.
  • Easy Access Feature: Right below the Offers Widget, you can access all the following features on your app home screen directly with a single click : Book a Doctor’s Consultation, Order Medicines, Get e-Card Details and View Policy Details.
  • Wellness Tab: The new Wellness Tab now gets you direct access to help Create a new Appointment, View all your previous appointments and also Manage all your registered Beneficiaries.
  • Insurance Tab: Clicking on the Insurance Tab will give you access to all your insurance management options that include: Tracking your Claims in real time, Getting your e-Cards, Viewing all your Policy details, Finding the nearest Network Hospitals, Opting for eCashless where you can get cashless treatment for planned hospitalizations, Intimating your hospital about upcoming Reimbursements and also Submitting Reimbursements that were incurred  from your earlier hospitalization expenses.
  • Records Option: Within the Account Tab, you now have a Records option, where you can view all your Health and Policy records in one place. Also included are the important Forms and Guidelines that you may be needing to refer to in case of any queries during your procedures.
  • MediBuddy Button: Right on your home screen, you can see the new MediBuddy button which can connect you to all your health care needs in one single click, quite literally! Clicking on the MediBuddy button will give you the option to Book a Health Check, Order Medicines online, Book a Consultation, Book specialized Lab Tests, Request for Home Health Care, Avail Dental Services, Ask for a Tele Consultation, Consult a Second Opinion and even Request a detailed Genome Study – all from the comfort of your home or office via your mobile phone! 

The MediBuddy Mobile App is the first app to bring forth an exclusive combination of both; Insurance and Health & Wellness elements, all in one single mobile platform! We’re proud to have brought you this customer-centric application which has been carefully designed with the sole intent to increase the ease, functionality and convenience for one person: You! So whenever you need any Inpatient Services, Outpatient Services, Claims Information or need to keep a strict track of your Health’s status, you know where to look!

With all these new features, we aim to build an active and robust community of aware individuals who are focused on being healthy and keen on digitizing their entire wellness and claim reimbursement needs. Once this community is up and running, we shall be rolling out our exciting Rewards Program as well. Stay tuned!

This is truly the future of Health Care, brought to you today! You’re Welcome.

Waterborne diseases shouldn’t be taken lightly. Consult a doctor on MediBuddy immediately if any of the symptoms last more than a few days.