scholarly journals An analysis on the different insurance policy in India and its role in economy growth and providing people with better life opportunities

2021 ◽  
Vol 12 (3) ◽  
pp. 119-123
Author(s):  
Dr Sumanta Bhattacharya ◽  
Bhavneet Kaur Sachdev
Keyword(s):  
Health Insurance ◽  
Insurance Industry ◽  
Health Sector ◽  
Domestic Saving ◽  
Insurance Policy ◽  
Form Of Life ◽  
Economy Growth ◽  
Maximum Benefit ◽  
Ancient Times ◽  
The Government

A update financial system is a very necessary for the economy growth, insurance industry provides freedom security for the future to all its citizen. In India the government and the insurance industry works together to provide maximum benefit to its people in the form of life and non-life insurance which includes health, travel and vehicle insurance, it is a very old industry, exiting since ancient times in different form, with privatization, we see a rapid rise in insurance industry, where people are saving along with there is domestic saving, FDI has amplified to 74% which has brough in capital income. Farmers, poor and vulnerable people have been benefitted with majority of the health insurance policy in India. we also see a rise in digital insurance. In FY21 the non-insurance recorded 5.19% growth in Growth Direct premiums, where as the market share for general and health insurance has escalated from 47.19% to 48.3% for FY20. In this pandemic the main focus in on health insurance, the government is bringing in new schemes for health sector and incrementing its insurance.

Het gezondheidsbeleid in België in handen van corporatieve organisaties

Res Publica ◽  
1995 ◽  
Vol 37 (1) ◽  
pp. 109-113
Author(s):  
Guy Peeters
Keyword(s):  
Health Insurance ◽  
Health Workers ◽  
Pressure Group ◽  
Insurance Policy ◽  
Sickness Insurance ◽  
Hospital Sector ◽  
Advantages And Disadvantages ◽  
The Social ◽  
Social Partners ◽  
The Government

Before the so-called 'bill Moureaux ', the health insurance policy in Belgium was contracted out by the government to the health workers and the health funds. Also in other sectors (hospitals), government contracted out. This subsidiarity has advantages and disadvantages.  Especially because of the unbearable budgetary excesses, this situation started to change since the beginning of the eighties, starting with the hospital sector. In the early nineties, the management of the sickness insurance also went through some radical changes. The budgetary envelope (budget objective) is now mainly established by those who finance the system, e.g. the government and the social partners (employers and workers), who must take their responsibilities. In this new perception, all partners must be made truly accountable.Government must pass on statistic material in order to be able to pursue a well-informed policy. It must also crank up some social debates, namely about the demographic ageing.Health funds and organisations of physicians need a further democratization. The health funds must accomplish at the same time several functions: pressure group, service and consumer defence.

Commentary on Canadian Health Insurance: Lessons for the United States

1993 ◽  
Vol 23 (1) ◽  
pp. 45-62 ◽  
Author(s):  
Theodore R. Marmor
Keyword(s):  
United States ◽  
Health Insurance ◽  
Insurance Industry ◽  
The United States ◽  
Congressional Hearings ◽  
Government Accounting ◽  
American Health Care ◽  
National Comparison ◽  
Health Insurance Industry ◽  
The Government

The Government Accounting Office's comparatively favorable report on Canada's National Health Insurance program (Medicare) prompted a firestorm of reaction: criticism from the health insurance industry primarily and praise from advocates of single-payer models of American reform particularly. Congressional hearings aired this controversy, and this article is a revised version of the author's testimony to the Government Operations Committee, June 18, 1991. The author examines the legitimacy of cross-national comparison as a general analytic tool and the lessons to be learned from North American health care comparisons in particular. In the final section he critically discusses two sets of myths about Canada's experience with universal health insurance: those regarding the desirability of the Canadian system itself and those questioning the transplantability (adaptability) of the model to the United States.

scholarly journals RECONSTRUCTION NATIONAL SOCIAL SATISFACTION SYSTEM FOR HEALTH FIELD IN THE AUTONOMY REGION WITH VALUE OF WELFARE

2018 ◽  
Vol 1 (1) ◽  
pp. 101
Author(s):  
Gunarto Gunarto
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
Government Regulation ◽  
Health Sector ◽  
Social Security System ◽  
Security System ◽  
Research Approach ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Government

Objectives to be achieved in this research To understand and analyze the National Social Security System Construction of Health Sector in the current positive law, to understand and analyze the weaknesses of the National Social Security System in the Field of Health today and to analyze and reconstruct the National Social Security System for Health Based on the value of welfare Research is expected to have both theoretical and practical uses that researchers use is socio legal research, this research approach is chosen to see how far the effectiveness of law in the prosperity of the community especially in health insurance coverage, here the law is not only seen in terms of its effectiveness but Also related to non-legal factors such as institutions related to the welfare of the community. The Legal System of the Health Insurance Program with the participation of BPJS is still very weak both in terms of the legal substance component, in providing equitable welfare in obtaining health services through the Health Insurance Program with. Strengthening Components of Legal Substances by changing Article 39 Paragraphs (1), (3) and (4) of Presidential Regulation No. 12 of 2013, Strengthening Legal Structure Components by Strengthening FKTP I on the regulation of Government Regulation, Strengthening Legal Culture Component by developing Culture of community law through continuous education to the community so that the community, the Government is not responsible for providing funds for Beneficiaries of Contribution (PBI).

Private Agencies for Public Purposes: Some New Perspectives on Policy Making in Health Insurance Between the Wars

1983 ◽  
Vol 12 (2) ◽  
pp. 165-193 ◽  
Author(s):  
Noelle Whiteside
Keyword(s):  
Health Insurance ◽  
Interwar Period ◽  
Social Insurance ◽  
Central Regulation ◽  
Insurance Policy ◽  
Public Subsidies ◽  
The Government ◽  
The Cost ◽  
The Unemployed

ABSTRACTThe approved societies, who were charged with the administration of health insurance in Britain, have long been blamed for the failure of the scheme to expand its coverage or scope in the interwar period. This paper takes a closer look at the administrative process and argues that societies were more vulnerable to central regulation than is commonly thought and were unable to resist cuts in public subsidies and extensions in liability introduced at their expense. They provided a convenient scapegoat for policies emanating primarily from the economic orthodoxy subscribed to by both government and the Treasury, modified to protect the unemployed during the slump. Health insurance policy was dominated to a large extent by the Government Actuary, who aimed to guarantee the cost effectiveness of the scheme. This paper also shows how administrative definitions and practices affected the classification of claimants to state social insurance at this time. It re-establishes the major weaknesses of the system, arguing that – in the light of recent discussions about reviving a system of national health insurance – we have much to learn from looking again at the experience of the interwar period.

scholarly journals THE CONTRIBUTION OF GOVERNMENT SPONSORED HEALTH INSURANCE SCHEMES TOWARDS INDIAN HEALTH SECTOR

2021 ◽  
pp. 165-171
Author(s):  
Dr.V.Pugazhenthi
Keyword(s):  
Health Insurance ◽  
Health Sector ◽  
Insurance Premium ◽  
Insurance Companies ◽  
Export Credit ◽  
Insurance Sector ◽  
Indian Health ◽  
Health Insurance Premiums ◽  
The Government ◽  
Health Insurers

Today, there are thirty four general insurance companies including the Export Credit Guarantee Corporation of India Ltd (ECGC) and Agriculture Insurance Corporation (AIC) of India and 24 life insurance companies operating in the country. Barring the AIC and ECGC, all other 32 insurers transact health insurance business, of whom six are stand-alone health insurers. Although there are number of insurers and different types of health insurance products available in the market, three-fourth health-insured Indians still gets covered only by a government-sponsored health insurance scheme (GSHIS) like PMJAY. Of all the health insurance premiums underwritten in the year 2019-20, 10 per cent came only from the GSHIS. In terms of number of persons covered, 73 per cent health-insured people are governed by one or other GSHIS. Looking at the profitability of the health insurer also, the incurred claims ratio is just 97.22 per cent in GSHISs. Thus, the health insurance premium, penetration and profitability—all of these are significantly sponsored and subsidized by the government through GSHIS, incorporating the public–private partnership (PPP) mode. This article details the role of GSHIS in the health insurance segment, taking the performances of the Indian health insurance sector in the year 2019-20. KEYWORDS: Government sponsored health insurance schemes, health insurance, health premium, incurred claims ratio, insurance, insurance regulatory and development authority, standalone health insurers.

scholarly journals Application of Machine Learning Techniques to Predict the Impact of Health Insurance on the Wellbeing of an Individual

2019 ◽  
Vol 9 (2) ◽  
pp. 3065-3070
Keyword(s):  
Machine Learning ◽  
Health Insurance ◽  
Large Scale ◽  
Insurance Industry ◽  
Financial Burden ◽  
Machine Learning Algorithms ◽  
Machine Learning Techniques ◽  
Insurance Companies ◽  
The Government ◽  
The Impact

The healthcare domain in India has suffered considerably despite the advancement in technology. Several financing schemes are endorsed by the insurance companies to lessen the financial burden faced by the government and people. Nonetheless, Health Insurance segment in India remains underdeveloped due to various complexities that it faces. This paper exploits a heuristic sampling approach combined with the ensemble Machine Learning algorithms on the large-scale insurance business data to realize the current shape of the Health Insurance industry in India. Through the courtesy of Data Mining and Data Analytics, it is plausible to furnish insights that assist the common people in acquiring closure that helps in the process of decision making.

scholarly journals Policy Implementation of Health Coverage for Indonesian Migrant Workers

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Risky Kusuma Hartono ◽  
Budi Hidayat ◽  
Pujiyanto Puji
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
Policy Implementation ◽  
Migrant Workers ◽  
Social Aspect ◽  
Health Coverage ◽  
Insurance Policy ◽  
The Social ◽  
Bilateral Cooperation ◽  
The Government

Abstract. The purpose of this research is to analyze the policy implementation of health coverage for TKI. This research uses a qualitative method with in-depth interview. The framework of this research consists of the aspect of the advisable policy, the implementation factors, and the schematic representation of the problem by using SWOT. The result of this research is the health insurance owned by TKI comes from TKI insurance, the membership of JKN, and insurance during their employment abroad. TKI insurance policy is the instruction of Law No. 39 of 2004 which regulates the obligation of the ownership of the social security and or insurance policy for TKI. However, TKI insurance has not been involved with the social aspect because the agency commercializes the coverage of TKI and it is not included a social security. The change of consortium may have decreased the ratio of claim’s values to the annual premium which is attributable to the decreasing complaint cases from TKI. In the implementation, TKI insurance has been assisted by a lot of agencies. However, the bilateral cooperation related to the coordination of health coverage among countries has not been maximized. This research concludes that the coverage of health insurance for TKI is still lower (curative) and the government's attempt to integrate the social security for TKI is important. The researcher suggests the government should comprehensively implement the health coverage for TKI by incorporating the principle of promotion and prevention. Keywords: TKI Insurance, Consortium, Law No. 39 of 2004, SWOT, Bilateral Cooperation

Private Insurance Reform in the 1990s: Can it Solve the Health Care Crisis?

1992 ◽  
Vol 22 (2) ◽  
pp. 197-215 ◽  
Author(s):  
Thomas Bodenheimer
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Insurance Industry ◽  
Private Insurance ◽  
Health Sector ◽  
The United States ◽  
Healthy Population ◽  
Health Coverage ◽  
Insurance Reform ◽  
Health Insurance Reform

A number of health insurance reform proposals have surfaced at the state governmental level in the United States. These include Medicaid expansion for the below-poverty or near-poverty uninsured, state subsidy to individuals and/or businesses for the purchase of health insurance, risk pools for the medically uninsurable, insurance industry–initiated reforms within the small group market, the promotion of “stripped down” insurance plans that reduce premium cost, and state mandating of employer-sponsored health insurance for the employed uninsured. All of these insurance reform proposals have serious limitations: (1) they fail to address the inequities of the underwriting principle by which older and sicker people pay more for health insurance than the young and healthy population; (2) they extend the illogical linkage of employment and health insurance; and (3) they do not slow the rate of health cost inflation nor do they contain a mechanism to finance broader health coverage through savings within the health sector. An alternative to insurance reform is the establishment of a social insurance program that brings the entire population into a single risk pool.

Management of Claims and Reimbursements: The Case of Mediclaim Insurance Policy

2002 ◽  
Vol 27 (4) ◽  
pp. 15-28 ◽  
Author(s):  
Ramesh Bhat ◽  
Elan Benjamin Reuben
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Health Insurance Scheme ◽  
Insurance Company ◽  
Insurance Policy ◽  
Insurance Scheme ◽  
Induced Demand ◽  
Voluntary Health Insurance ◽  
General Insurance ◽  
The Government

The Mediclaim scheme run by the government- owned General Insurance Corporation (GIC) of India is currently the only private voluntary health insurance scheme available in India. This scheme has been in operation since 1986 and from time to time a number of revisions has been made to address the needs of its clients. The analysis of claims and reimbursements under this scheme is scanty. This paper analyses 621 claims and reimbursements pertaining to policy initiation years 1997- 98 and 1998-99 of the Ahmedabad branch of GIC's subsidiary. The study estimates that about a third of claims amount increase is due to the problems of adverse selection or provider- induced demand. The analysis of breakup of reimbursements suggests that more than one-third of reimbursements are made towards doctor's fees, followed by diagnostic charges which account for about one-fourth. The findings also suggest that the insurance company took on an average 121 days to settle the claim.

Eliminating Hepatitis B from Bangladesh by the Year 2030

2020 ◽  
Vol 38 (3) ◽  
pp. 145-149
Author(s):  
Md Golam Mustafa ◽  
Md Shahinul Alam ◽  
Md Golam Azam ◽  
Md Mahabubul Alam ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Health Workers ◽  
Health Sector ◽  
Public Health Problem ◽  
Integrated System ◽  
Hbv Infection ◽  
Diagnosis And Treatment ◽  
Major Public Health Problem ◽  
Medical Institutions ◽  
The Government

Worldwide, hepatitis B virus (HBV) infection is still a major public health problem. Bangladesh having a large burden of HBV infection, should be a major contributor towards it’s elimination by 2030. The country has been making progress in reducing incidence of HBV infection during the past decades. The progresses are mainly due to large vaccination coverage among children and large coverage of timely birthdose vaccine for prevention of mother-to-child transmission of HBV. However, Bangladesh still faces challenges in achieving target of reduction in mortality from HBV. On the basis of targets of the WHO’s Global health sector strategy on viral hepatitis 2016–2021, we highlight priorities for action towards HBV elimination. To attain the target of reduced mortality we propose that, the service coverage targets of diagnosis and treatment should be prioritized along with vaccination. Firstly, improvements are needed in the diagnostic and treatment abilities of medical institutions and health workers. Secondly, the government needs to reduce the costs of health care. Thirdly, better coordination is needed across existing national program and resources to establish an integrated system for prevention, screening, diagnosis and treatment of HBV infection. In this way, we can make progress towards achieving the target of eliminating HBV from Bangladesh by 2030 J Bangladesh Coll Phys Surg 2020; 38(3): 145-149

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