Take charge of your health, insure it

Jan 11, 2005
Publication : Deccan Herald

Biocon Foundation and Narayana Hrudayalaya have initiated a health insurance scheme targeted at rural populations, starting with Karnataka. Priyanka Haldipur gives an insight into the project.

While on the glam side, botox is making its advent in the Indian market and hookah bars are becoming the latest craze with the crowds here, a bite of the reality pie might expose one to less talked about bitter truths. With every passing day, more and more Indians in rural areas are falling prey to diseases. Some major, some insignificant. The lack of capital leaves them with no other choice but to ignore the ailment, until it worsens and pushes them into the jaws of death.

Talk has been building up in every nook and corner to address this issue and work towards ridding the rural society of it. However, when it comes to action, the stage has so far been I bereft of activity.

So far... because Arogya Raksha Yojana, the recently-introduced health insurance scheme for the rural masses, an initiative of Biocon Foundation and Narayana HrudayaIaya in collaboration with ICICI Lombard General Insurance Company Private Limited, shows immense promise of changing things for the better.

"Health insurance is normally aimed at affluent urban people. Ignoring rural people who form such a big part of the Indian population, will cause huge problems in the long run," says Kiran Mazumdar-Shaw, CEO, Biocon Foundation. "The objective of Arogya Raksha Yojana is to provide quality health care at a reasonable cost to those very masses and route out indebtedness to money-lenders," she adds.

The first Arogya Raksha Yojana centre with a clinic, office and BioCare Pharmacy was inaugurated by Prof Muhammad Yunus, Managing Director, Grameen Bank, Bangladesh at Huskur Village, Anekal taluk, Karnataka, on December 19,2004. "Currently, a pilot study is being conducted in Anekal taluk where all its four hoblis (cluster of villages) - Sarjapur, Attebele, Kasaba and Jigini, consisting of 250 villages and 6,00,000 people will get to be a part of the scheme. Based on its success there, the implementation will spread to states other than Karnataka," says Dr Devi Shetty, Narayana Hrudayalaya.

On why ICICI chose to associate itself with this project, Smitha Aggarwal, Head -Rural and Agriculture Business Group, ICICI Lombard General Insurance Company says, "We have always been committed towards providing insurance to rural. Health risks are the highest risks they face, and we want to give them all the risk protection they deserve, through this project."

"The Arogya Raksha Yojana derives inspiration from management guru CK PrahIad's business model that propagates bottom up planning, where the huge market of the poor that exists in India needs to be tended to.

What the scheme entails
Free out-patient consultation can be availed as part of Arogya Raksha Yojana. Generic medicines at special rates from network hospital pharmacies and BioCare pharmacies; diagnostic tests at discounted rates; hospitalization (without surgery) and free surgical interventions with 100 per cent cashless facility for surgical treatment and medical admissions up to the covered amount, are also included.

Surgical cover
ver 1,600 listed surgeries such as hernia, appendicitis, hysterectomy and cardiac bypass are covered. The scheme covers both pre and post operative surgical treatments. However, it does not include prosthesis and implants including valves, grafts mesh, stents, nails, screws; joint replacement surgeries; transplants; burn cases; malignancies - chemotherapy; cosmetic surgery; medico-legal cases; angioplasty; auto-immune diseases; vaccination; dental surgeries; skin grafting for wound; spectacles, hearing aids; dialysis; ambulance services; food and other non medical expenses, vitamins and tonic, and any other expenditure unrelated to the illness/ hospitalisation..

Medical cover
Free out-patient consultation can be availed as part of Arogya Raksha Yojana. Generic medicines at special rates Hospitalisation (without surgery) is covered along with three days of hospitalisation which includes charges towards room, professional fees and routine investigations. Certain conditions apply, such as treatment can be availed only in the general wards at network hospitals. Individual members can avail one admission per year (maximum- three hospital days). Members who have enrolled under the 'family pack' are eligible for a maximum of 50 pc of the total number of enrolled members. The cover excludes medicines and medical consumables, oxygen and ventilator charges.

Medical cover
Free out-patient consultation can be availed as part of Arogya Raksha Yojana. Generic medicines at special rates Hospitalisation (without surgery) is covered along with three days of hospitalisation which includes charges towards room, professional fees and routine investigations. Certain conditions apply, such as treatment can be availed only in the general wards at network hospitals. Individual members can avail one admission per year (maximum- three hospital days). Members who have enrolled under the 'family pack' are eligible for a maximum of 50 pc of the total number of enrolled members. The cover excludes medicines and medical consumables, oxygen and ventilator charges.

Out-patient services
This includes free out-patient consultation, free registration only at network hospitals, investigations and diagnostic tests, low cost, high quality generic medicines provided at special prices.

Eligibility
The applicant should be a resident of Anekal taluk, between 0 and 70 years of age on the date of enrollment. Proof of residence for family (ration card / voters ID / driving license/ passport / PAN card / bank account) should be produced.

The fee
The 'Individual Scheme' comes up to Rs 180 per member per year, As part of the 'family scheme,' it works up to Rs 180 per member per year for two members, Rs 150 per member per year for three members, and Rs 120 per member per year for four or more members.

Network hospitals
aome of the network hospitals include Narayana Hrudayalaya (Bommasandra Industrial Area), CSI Hospital (Hazarat Kambal Posh Road), Chinmaya Mission Hospital (CMH Road), Devi Eye Hospital, ACTS Health Centre, Sri Vinayaka Hospital (Chandapura), N R Hospital (Bangalore-Hosur Highway) and FOSA Hospital (Bannerghatta Circle).
"There is a catch-22 situation at work. You need patients in order to maintain hi-tech medical equipment. But the equipment happens to be so expensive, that the patients can't afford it. Hence a low-cost health insurance scheme such as our's meet their need," says Devi Shetty.
Kiran further states, "The price of medicines is considerably decreased as we ourselves handle the marketing and distribution of drugs. The network hospitals and BioCare pharmacies lead to economies of scale." The organisers of this scheme truly believe that prevention is better than cure, and have hence arranged for volunteers to educate the people in the villages through presentations and visual aids, about preventing the various diseases they are susceptible to. Reducing infant and maternal mortality is another one of their prime aims.
"The biggest challenge is to break psychological barriers and prove that there are no vested interests on our part. We want one and all to realise that this will become a huge change maker in our country," Kiran smiles. Judging by the passion and determination behind it, this vision called Arogya Raksha Yojana deserves all the success due to it, and more.
Contact 080-28082153 for more details..