HEALTH INSURANCE SECTOR IN INDIA: CURRENT SCENARIO

Topics: Health care, Insurance, Health economics Pages: 12 (3558 words) Published: September 21, 2013
Roll No. 09BAL052
Nirma University

Institute of Law

VII Semester B.A.LL.B. (Hons.)Course 

Synopsis on the subject of “Banking and Insurance Law”
For the academic year 2012-13 
On the Topic:

“HEALTH INSURANCE SECTOR IN INDIA: CURRENT SCENARIO”

Prepared & Submitted By
Rajat Tandon
(09BAL052)

Chapter-1
Introduction and Research Methodology:

1.1 Introduction:
Health and health care need to be distinguished from each other for no better reason than that the former is often incorrectly seen as a direct function of the latter. Heath is clearly not the mere absence of disease. Good Health confers on a person or groups freedom from illness - and the ability to realize one's potential. Health is therefore best understood as the indispensable basis for defining a person's sense of well being. The health of populations is a distinct key issue in public policy discourse in every mature society often determining the deployment of huge society. They include its cultural understanding of ill health and well-being, extent of socio-economic disparities, reach of health services and quality and costs of care. and current bio-mcdical understanding about health and illness. Health care covers not merely medical care but also all aspects pro preventive care too. Nor can it be limited to care rendered by or financed out of public expenditure- within the government sector alone but must include incentives and disincentives for self care and care paid for by private citizens to get over ill health. Where, as in India, private out-of-pocket expenditure dominates the cost financing health care, the effects are bound t be regressive. Heath care at its essential core is widely recognized to be a public good. Its demand and supply cannot therefore, be left to be regulated solely by the invisible had of the market. Nor can it be established on considerations of utility maximizing conduct alone.1 Health insurance in a narrow sense would be ‘an individual or group purchasing health care coverage in advance by paying a fee called premium.’ In its broader sense, it would be any arrangement that helps to defer, delay, reduce or altogether avoid payment for health care incurred by individuals and households. Given the appropriateness of this definition in the Indian context, this is the definition, we would adopt. The health insurance market in India is very limited covering about 10% of the total population. 1.2 Hypothesis:

The Researcher assumes that all projections of health care in India must in the end rest on the overall changes in its political economy - on progress made in poverty mitigation (health care to the poor) in reduction of inequalities (health inequalities affecting access/quality'), in generation of employment /income streams (to facilitate capacity to pay and to accept individual responsibility for one's health ) in public information and development communication (to promote preventive self care and risk reduction by conducive life styles ) and in personal life style changes. 1.3 Research Methodology:

In this endeavour, both primary and secondary sources of data have been used to prepare the present paper. Further, it must be noted that the present paper discusses in detail the Indian position in this regard. 1.4 Object :

The purpose of this paper is to study the Situation exists in a scenario where health care is financed through general tax revenue, community financing, out of pocket payment and social and private health insurance schemes.

1.5 Scope :
The Scope this Research is limited to the extent of Indian position in this regard, while ignoring the foreign Scope.

Chapter-2
Health Insurance:
Health insurance in a narrow sense would be ‘an individual or group purchasing health care coverage in advance by paying a fee called premium.’ In its broader sense, it would be any arrangement that helps to defer, delay, reduce or altogether avoid payment for health care incurred by individuals...
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