Dr. Daleep Pandita
With the ongoing exponential increase in number of active cases of COVID-19 and subsequent deaths due to this pandemic, now its consequences have assumed different challenging dimensions day by day. World Health Organisation ( WHO) predict its prevalence for long time and our medical experts also foresee its prolong continuation in India. Conclusively, people have no alternative but to change their mindset and adopt to live with this prevailing COVID-19 atmosphere. Now mostly people at large follow proper preventive medical advices and have also acquired sufficient awareness on non medical measures particularly on strong will power with positive attitude, meditation, yoga, physical exercise, immunity boosting diet etc. which are easily affordable and less expensive, have successfully reduced the spread of this pandemic to a great extent.
But this alarming rise in number of new positive cases requires quality medical facilities on large scale which is resulting in to huge financial loss. Providing low cost affordable and quality treatment to these active COVID – 19 patients is the urgent need of the hour. As it requires Intensive Care treatment ( ICU ) so normally people do not expect such heavy expenditure on this long term hospitalization. Less expensive Government hospitals are almost full in their ICU capacity with active patients while private medical institutes though providing better medicare, are cost threatening. Getting good quality medical facility at affordable cost remain basic expectation of every patient but large number of COVID – 19 cases and the hefty amount involved in its treatment, dilute this fundamental right.
Under such uncertain risky circumstances resulting in to heavy financial burden, health insurance provide much needed financial alternative to this burning problem, especially for poor citizens. Although world’s largest health insurance scheme, Pradhan Mantri Jan Arogya Yojna ( PMJAY ) which covers more than 55 crore persons through about 11 crore families address this important issue to some extent. But it lacks sustained publicity campaign in conveying its benefits down to the masses that this paperless insurance scheme also provides cashless cover on the treatment of COVID-19 up to Rs. Five lakh per family on floater basis. PMJAY covers expenses incurred on hospitalization including room rent, expenses for tests and diagnostics and even ventilator charges essentially required for treatment of COVID-19, that is provided at more than 16,000 designated empanelled hospitals all across the country. But the cost of laboratory tests incurred by COVID -19 negative suspects , Personal Protection Equipments kits ( PPE ) and other related preventative expenses are not payable under this scheme
Government must ensure proper monitoring to maintain check on quality and cost of treatment besides control to inflate healthcare mechanism for large number of COVID-19 patients
Under recently launched Pradhan Mantri Garib Kalyan Yojna (PMGKB ) the New India Assurance Company ( NIA ) has insured more than 22.12 lakh healthcare workers of India across grades, including paramedics, nurses and ASHA workers, who are on the frontline of battle against COVID-19 for a cover of Rs. 50 lakhs per person. While this tailor made comprehensive personal accident insurance scheme encourage our medical fraternity but leaves behind all other connected warriors like forces, administration and many more to take care of their financial liabilities in case of their head on battle with COVID – 19.
So under the prevailing economic recession, addressing this health related financial risk involved in treatment of COVID-19 patients, assumes greater importance and the only available best option for a common citizen remains to avail health insurance product. As all the existing health insurance schemes of the country does not cover the entire COVID – 19 expenditures, so Government of India along with the Insurance Regulatory Development Authority (IRDA) is strongly contemplating to address this serious issue urgently. They have prevailed upon all the insurers of the country to come up with low premium short period comprehensive medical insurance scheme, to take care of health risks of its citizens caused by ongoing Corona virus pandemic, setting July, 10 as its deadline. This standard indemnity based policy have been asked to be underwritten without any prior medical examination though having acceptable waiting period. It required to cover all types of COVID – 19 related expenditures including home care, AYUSH treatment, expenses incurred on burial / funeral and Co-morbid conditions. The scheme shall be easily available even deep at rural levels, with its cross selling through various financial outlets like banks, post offices, non banking financial institutions etc. having wide sustained publicity campaign to make it purposeful.
( The author is Senior Divisional Manager with Govt. of India insurer and Nodal Officer of J&K for COVID-19 Health Insurance Scheme )
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