Friday, June 2, 2006
Over 30,000 families living below the poverty line in Asia?s largest slum at Dharavi may soon have insurance cover for their medical expenses and regular health check-ups, thanks to a unique care model.
The scheme focuses on partnership between general physicians and the poor families through a health maintenance organisation (HMO), supported by a general insurance company and micro-financing institutions.
A year?s research by actuaries has gone into the making of this model, being developed by RD Lele, an eminent physician of Mumbai. The pilot project is likely to start soon. The premium for health cover and the contours of the policy will be designed on the basis of data collected from the pilot project.
A survey carried out by actuaries in the Dharavi slums revealed that, on an average, a family below the poverty line spends Rs 75 to 300 per medical transaction and Rs 5,000 annually on healthcare.
General physicians usually overcharge the poor and prescribe unnecessary diagnostic tests for even minor ailments. By forming a co-operative scheme with physicians, the primary care cost will be brought down considerably under the scheme.
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Source: Business Standard