ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Mayur TrivediSubscribe to Mayur Trivedi

Designing a Framework for Benefit Packages

Development of an essential health package requires explicit prioritisation on the basis of a country’s characteristics. A practical framework is presented to determine an EHP, considering coverage and equity perspectives for service delivery, financial protection and morbidity burden in the population. An analysis of morbidity data, unmet need for treatment, and impoverishment due to out-of-pocket spending reveals that a significant reduction in oop expenditure and impoverishment is possible through targeted inclusion of potentially high impoverishment-causing morbidities in EHPs. Such an approach may offer the desired flexibility in decision-making to policymakers, without compromising on benefits transferred to the needy.

Health Insurance: Beyond a Piecemeal Approach

Instead of different ministries taking initiatives to provide health insurance coverage for the areas or populations that are under their jurisdiction, it is important for planners to understand that parallel schemes run on public money can only introduce inefficiencies and wastage into the system. It is necessary to plan the spread of health insurance on a national scale and to set up an apex body that would be in charge of implementing health insurance in the country.

Social Health Insurance Redefined

This paper looks at the concept of social health insurance (SHI), the form in which it currently exists in India, the issues and constraints in scaling up and innovations in SHI that may be possible in the existing system, especially in the context of other forms of health insurance. The health system in India is ripe for moving towards ?Coverage for All? which meets the ?Health for All? objective to a great extent.

Third Party Administrators

This paper attempts to understand the role of TPAs, and examines the issues that need to be taken into account while evaluating their usefulness and functioning. TPAs, in spite of their importance in enabling accessibility to insured healthcare, cannot be seen as a panacea for the problems of the health sector.The TPA system should be regulated and checked in order to ensure that consumer interest is not compromised.
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