Is it possible to reduce health care costs?

Is it possible to reduce health care costs?

It is very easy to increase costs. The challenge comes when you have to answer question
“Is it possible to reduce health care costs?”

The truth is yes, it can be reduced if Tiger biscuits can be produced packed transported & then sold at retail level at Rs.50 per kgm by a reputed company Brittania- then why it is not possible to reduce costs when it comes to Health care.

In health care economies can be achieved by
(a)Standardision on design of hospitals
(b)Standardisalon on equipments to be procured/ installed
(c)Use of generic medicines vs branded medicines

(d)Effective procurement of equipment/medicines by hospitals forming consortium

We are sure the cost can be brought down by 25% and the benefit can be passed on to the consumers.

Consolidated document containing all terms and conditions on health insurance to be issued by Irda

There have been so many notications pertaining to health insurance that Irda may comeout with a conslidated document having all terms and conditions pertaining to all players( Insurance Companies,TPA,s,Intermediaries). This will help all players/customers to refer to one document and have all the queries answered.

If this comes out -it will be a very good step. We welcome this proposal.

OPD coverage to make beginning in Indian Health Insurance

Non coverage of OPD has been one of the major weakness of Indian Health Insurance policies.
As a part of RSBY pilot project is being launched in Puri ,Orissa and will be followed in Mehsana, Gujarat.
We are sure this will result in reduction in claim figures in these pilot projects and scheme will extended to all over the country.What ever happens to RSBY is ultimtely going to spread to all the policies.

TPA,s should provide service to Insurance Companies only

In the recent past we have been hearing that TPA,s have started providing services to corporate clients inmanaging their health care schemes.

Irda does not wish this to happen.This is a good news.Insurance industry lost some of the corporate clients where the cliam ratio was much less than 100%.As a result clients wwhich were adding to the favourable margins were being lost.

PSU's still retain 59% market share of Indian health insurance market (2010-11) of Rs.11145 crores

The health insurance figures for the year 2010-11 are available and PSU's have achieved premium figure of Rs.6578.64 crores vs Rs.4949.67 crores(2009-10). This is 59.02% market share vs 59.09% market share which was achieved during last year.

Health Insurance Premium of Indian Insurance Companies 2010-11 vs 2009-2010

You will notice that every company has shown growth in business with exception of Chola.

Growth during the year of this portfolio is 33.05% and 5 top insurance companies and their market share are:

ICICI Lombard deserves appreciation for taking up 4th position as a result Oriental is now at 5th position in the list. Star Health has crossed figure of Rs.1000 crores by touching figure of Rs.1232.44 crores.

Our comment is- health insurance is the fastest growing segment but even then a lot is to be achieved as we have large population and it needs to be covered.

Some are going & some are coming

Bharti group has sold Bharti AXA (both life & non Life) to RIL (Mukesh Ambani Group). DLF Pramerica is being sold to HCL (Shiv Nadar Group). Future Generali (Kishore Biyani Group) is looking for buyers for both of its Insurance companies.

After tasting the attraction of Insurance sector many well known names /business houses have decided to leave.

At the same time some are getting in this sector .Mahindra & Mahindra is entering non life business. . Magna is also entering non life. Edelweiss is entering Life business.Religare Health should be operational in near future.

Delegations of many foreign companies have been visiting India frequently and have been looking for partners. Some of these are:
Cigna
United
Discovery
Samsung Fire & Marine
….

Let us welcome those who are entering and bid goodbye to those who have left.

CORIS Gipsa TPA JV is not coming

There were indications that CORIS Gipsa TPA JV will become operational by end of 2011 and as a result of the same New/National/Oriental/United (4 PSU’s) will shift their TPA work to the new company.

Tenders were floated and Coris, a French company was selected. Suddenly we find that JV is being dropped. Tendering/Selection process has come under cloud and it was decided by the high ups to avoid negative publicity by dropping this JV.

May be it is the end of the JV idea. Let us wait & watch.

Emphasis is needed on preventive cure

Emphasis is needed on preventive cure.

More and more emphasis needs to be put on preventive cure to reduce hospitalization claims. We always thought that good hygiene is important for healthy life but correlation of brushing teeth twice leading to lower cardiac illness risk is a good and interesting study. This has appeared as a news item in TOI.

Health Insurance portability is delayed

Health Insurance portability is delayed.

In one of my blog I had written that portability of health insurance is having complexities and it will take much longer time to become effective. We have been advising clients that do not postpone buying of Health Insurance policy for portability conditions to be known and being effective. This has happened as the portability is delayed from July 1, 2011 to Oct 1, 2011.

Frauds have no limit in insurance claims

Frauds have no limit in insurance claims.

The following news item is an eye opener, where the person concerned tried to have a claim by taking his father’s death and even managing documents required for lodging claim.

The question before us is:

Was the claim lodged with American Insurance Company, who asked the investigator to investigate the case?

Is it that Indians have stared buying life insurance from foreign insurance companies in foreign?We have started hearing that some people are now buying health insurance outside India because of better coverage.