Health insurance melt down in India likely!

Posted by KETAN VAGHOLKAR on Sun, Dec 25, 2011  
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Health insurance segment in our country has grown significantly over the past decade.This has been fuelled by escalating health costs in urban settings. The growth of large corporate hospitals has skewed the growth in health care costs in a very dangerous form.For e.g. if a patient is to undergo a appendicectomy operation in a private nusing home not exceeding 20 beds, it would cost him approximately Rs. 30k. Whereas if the same surgeon was to operate upon the same patient in a 5 star corporate hospital it would cost approximately 75k to 100k depending upon the nature of room availed. It is astonishing to observe that the same surgeon performing the same operation , but such significant difference in the expense. Who is to bear the brunt? it is the insurance company. Besides this phenomenon which is commonly seen another phenomenon which is also to be seen in few dingy private nursing homes is swapping of insurance policies. If a person A is insured, but his brother B requires surgical treatment then all the reports and case papers are prepared in the name of person A in order to avail the insurance facility. These scams are ocurring quite frequently especially in the perpheries where insurance companies find it difficult to send their inspection squads. Third issue is qualifications. It is observed that quite a few doctors  use postnominal letters such as MD or MS without writing the university. It is observed that fake degrees are being given by fake universities situated on island countries  in the Arabian sea and in the Carribean area.The sad truth of these fake degrees is that they are not even recognized in those island countries. I think it is neccessary for Insurance companies to check with Indian Medical register website before accepting  claims submitted by such fake postgraduate degree holders. Viewing the whole scenario it is obvious that we are in a state of chaos. Unless strict protocols are enacted a lethal melt down is inevitable in the health insurance sector endangering the lives of the common man.


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