Page 11 - Insurance Times August 2019

Health Insurance

News

Manipal Group makes Healthcare policy solutions based on RSBY, suggests
space in health insurance book
biz In spite of the scheme Rashtriya Swasthya Bima Yojna (RSBY), the children and
the mothers did not receive healthcare benefits because
Seeing the potential in the country’s the number of earlier schemes would be spent most of
health insurance sector Manipal the time on the head of the family. Based on a study of
Group increased its stake in the joint Rashtriya Swasthya Bima Yojna (RSBY), a new book aims
venture (JV) to 51% buying TTK to share insights that may be useful for other healthcare
Group’s entire shareholding in the schemes including the Pradhan Mantri Jan Arogya Yojna (PMJAY).
company which is pending regulatory Written by social sector expert Sonalini Khetrapal, the book "Healthcare for
approval. It must be noted that India's Poor – The Health Insurance Way" sheds light on RSBY's implementa-
Bengaluru-based Manipal Group en- tions, success and its drawbacks to suggest improvement in other healthcare
tered the insurance business last year.
schemes, publisher Academic Foundation announced. While speaking at the
Ranjan Pai, chairman of Manipal Edu- launch event, Minister of Health and Family Welfare Harsh Vardhan said that
cation and Medical Group (MEMG), the book has "findings that are very important for us to understand".
during an interview, spoke about the "Although the RSBY was hurriedly launched, in the context of the scheme by
group’s foray into the health insur- the present government, there is a big difference in the spirit in which these
ance business, investments, opportu- schemes were launched. I am very confident that India has the capacity to pro-
nities, and plans ahead. vide healthcare for its people and provide insights for the rest of the world,"
When asked about the key factor be- the minister said. Focusing on universal healthcare as its backdrop, the book
hind his investment into the health throws light on contract design and looks at the incentive structures created
insurance space, he said, “We tried by the division of roles, responsibilities and relationships within the contracts.
working with Cigna Corporation The book also examines the regulatory and political environment, and the in-
when they first entered India. It is stitutional capacity to deliver quality services.
our long-term play focused on our "A study published in the British Medical Journal found that in 2011-12, 5.5 crore
core business. Today India has a people were pushed into poverty due to healthcare costs. As India works to
mature insurance market. People implement the potentially game-changing PMJAY program, it is very important
are now buying insurance products. for policymakers to understand in what ways RSBY succeeded and where it
And I feel this change started hap- failed." the author said.
pening two-three years back. That’s
the time we seriously started explor- OPD cover
ing the space and when this oppor- Out patient department (OPD) cover is offered as part of health insurance poli-
tunity arrived we grabbed it. So far, cies. OPD treatment refers to procedures that do not require a stay in the hospi-
it has worked out well. TTK was tal and are done in the out-patient department. Apollo Munich and Max Bupa
anyways looking at getting out of the offer cashless OPD facility. However, there are limits to how much of OPD expenses
business so we found it easier. And will be covered in a year. Max Bupa's GoActive family floater plan offers 10 cash-
both Cigna Corporation.” less or reimbursable consultations with a cap of Rs. 500-600 per consultation.

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