"Health Care for ALL"
"Health Care For All"
by P.T. Choudary, Chairman IDEAz
Quotations for consideration:
- "Health is not valued till sickness comes."- Dr. Thomas Fuller .
- "The belief that all people are equal and that no one should be denied the best of medical services is idealistic, but impractical and leads to ballooning costs. The British National Service is a failure. The U.S style medical insurance schemes are expensive. The ideal of free medical care goes against the reality of human behaviour. To prevent misuse, and to keep waste and costs in check and prevent people from under valuing what is offered, it is necessary to require co-payment from the user." - Lee Kuan Yew .
- "Humans respond to incentives. How an agent or doctor advices or treats you corresponds directly to the incentive or fees he may receive, directly or indirectly, in advising or prescribing to you a particular action or treatment" - Anon
- Health Care is very essential especially for the very young and the very elderly.
- The costs for Health Care are prohibitively high and hence out of reach of most.
- Health Care can be within reach of all vide a properly designed universal coverage programme, as the more inclusive the program the less the individual premium.
- The demographic distribution in favour of the expected increase of the working population must grow healthy and only thus be beneficial to all.
- Today only 20% of Indians have any sort of health Insurance, and there is generally no protection for those beyond 65 years age.
- Gujarat, outsourced Child deliveries to Doctors on a contract fee of only about ₹ 2000/- each and yet succeeded in reducing the maternal death rate in Child birth across 4 Lakh deliveries to less than 4 % of what it used to be, from an earlier 1600 to only 64.
A voluntary health insurance scheme will be ineffective as the young and healthy will opt out increasing the premium on the rest. It should therefore be a broad based mandated coverage on community rating basis. Not allowing for different premiums based on different criteria, except perhaps age and geography etc and not excluding previous or chronic illness will be the most economic and effective way to provide basic Universal Health Care at a reasonable cost. Such universal coverage will also prevent the ills of Data Mining that may otherwise allow the Insurance Companies to set discriminative Premium rates.
"Effective Insurance depends on mutual ignorance. The more the individual or the Insurance Company knows of the risk of disease the less effective the insurance." - Tim Harford
The definition of 'Basic', as a general directive principle, could be decided on by a Group of Doctors, NGOs and Politicians etc and reviewed say every 5 years. Additional levels of care could be provided as riders at extra cost on a voluntary basis, eg: Dr. Devi Prasad Shetty's 'Asha Health Care Programme'. Also all hospitals / clinics / nursing homes etc should be rated as