Understanding basics and challenges of U.S. Health Insurance and lessons India can learn from them

United States has predominantly two types of insurance – Private and Public.  Private health insurance is often offered through employers or other organizations. Public insurance is funded by government broadly through two categories – Medicare and Medicaid.  Medicare is funded through federal government for aged population who are age 65 or older. Medicaid is state-run government insurance program that helps some people with lower income for medical care.

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Is Health Insurance the answer to India’s healthcare woes ?

Well thats the question I have been asking myself all these years. Now seriously, the only country that spends 17 % of its GDP on healthcare and is ranked among the best healthcare systems in the world providing care to more than 300 million people is the United States of America. And the healthcare system there is run by Health Insurance firms.

India on the other side spends far lower, it is estimated that we spend about 5.7 % of its GDP on Healthcare. Almost 75% of it is in the private sector. As a matter of fact almost 80% of outpatients, pharmaceutical spend and ambulatory care is covered by the private sector. When it comes to inpatient it is 50-50 % with government and the private sector sharing the spend. It is only in the primary care and preventive space that government bears almost 95% of the spend. All immunization programs for example are run by the government.

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Women in India continue to ignore their health says new study

Women are the backbone of the family as homemakers, as well as, employees in the workforce. Since they are often engaged in taking care of home and their work places, most of them ignore their routine health check-up, unless a situation warrants it. As a country we continue to turn to males in the family as the main bread winner. A survey, conducted by Apollo Munich Health Insurance in collaboration with Nielsen India Pvt. Ltd. in 19 cities found that despite a rise in health insurance claims filed by women, few women are coming forward to buy health insurance. Given the low awareness for the need of a health cover; the number of women opting for products that are tailored for them, has significantly gone down.

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Apollo Munich Health Insurance wins Golden Peacock Award for Risk Management 2017

Leading standalone health insurer, Apollo Munich Health Insurance has been awarded the Golden Peacock Award for Risk Management (GPARM), instituted by the Institute of Directors (IOD) and recognized as the hallmark of excellence worldwide. The award was conferred on the health insurer for its robust risk management practice and steadfast focus on identifying and averting any risk that can impact its business and stakeholders.

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Do we have the awareness and access to adequate health insurance in India

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India does not have adequate health insurance cover. Today around 20 % of the population is covered by some kind of health insurance. This includes the insurance provided by the government through the Rashtriya Swashtya Bima Yojana. Broken down by the Urban and Rural segments, that amount to 12 % of the Urban population and around 13% of the rural population have insurance. This is data from the latest National Sample Survey released by the government.

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