The term health insurance is generally used to describe a form of insurance that pays for medical expenses. It is sometimes used more broadly to include insurance covering disability or long term nursing or custodial care needs. It may be provided through a government-sponsored social insurance program, or from private insurance companies.
India spends about 6.5 to 7% of GDP on Health care (official estimates around 6%) out of which 1.2% is in the Govt. sector (this accounts for 22% of overall spending) and 4.7% in private sector (78% of overall spending).
According to recent news report Health insurance continues to be the fastest growing segment with annual growth rate of 55%. Health Premium has risen to Rs. 3300 crores in 2006-2007.
As per the recent reports from various agencies the Health sector has the potential to become a Rs. 25000-crore industry by 2010 .
On August 15, 2007 Prime Minister has announced Rs 2000 Crores for Health Insurance for poor citizens. We foresee that this amount will be partly in form of subsidy therefore during calendar year 2008 we can expect Health Insurance premium to touch figure in the range of Rs 10,000 Crores.
CHI is “any not-for-profit insurance scheme that is aimed primarily at the informal sector and formed on the basis of a collective pooling of health risks, and in which the members participate in its management.”
On August 15, 2007, Prime Minister Manmohan Singh announced the creation of a new health insurance scheme; the Rashtriya Swasthya Bima Yojana or RSBY to protect the health of poor people. (The scheme was formally launched on October 1, 2007)
The selection of the health insurance provider shall be done by the state/implementing agency through tendering process inviting both Public and Private Insurers for better terms of reference. The State Government would formulate the projects and determine the implementing agency such as Insurance Trust/ Insurance Cell/Mother NGO etc. to monitor/supervise the scheme and integrate with insurance company. This would be further monitored at State and Central level.
The State Government will put in place a well defined mechanism for monitoring and evaluation of the pilot project at the time of its implementation. At the Central Government level, the Cell constituted for examining project proposals shall also periodically monitor and evaluate the performance of each pilot project with a view to evolving workable models which can be up-scaled for wider application.
Quality of service when facilities are owned by the plan giver; &
Give feasible alternative to community based organisations and movements exist in India. Only thing is to regulate the providers and to legislate so that the community health insurance programmes find a space within the Indian insurance context.