Question

Directions (Q.6 -10): Read the following passage carefully and answer the questions given below them. Certain words/phrases have been printed in bold to help you locate them while answering some of the questions. Several studies have pointed out that health insurance in India suffers from lack of scale, covering only about 29% of the households surveyed under the National Family Health Survey-4, that too in a limited way. The health-care system also lacks regulation of costs. There is asymmetry of information, with the insured member unable to assess the real scope of the policy or negotiate the terms with the provider. Questions such as these led to the enactment of a new health-care law in the United States during the Barack Obama administration, whereby strict obligations were placed on insurers and unreasonable exclusions removed. India’s health insurance and hospital sectors closely follow the American pattern, and are in need of strong regulation. This is necessary to define costs, curb frauds and empower patients. As the Delhi High Court has observed, exclusions cannot be unreasonable or based on a broad parameter such as genetic disposition or heritage. Insurance law has to be revisited to also ensure that there is a guaranteed renewal of policies, that age is no bar for entry, and pre-existing conditions are uniformly covered. Problems of exclusion will be eliminated if the payer-insurer is the state, the financing is done through public taxes, and coverage is universal. Given its stated intent to ensure financial protection against high health costs, India should adopt such a course. The short-term priority is to remove discriminatory clauses in policies and expand coverage to as many people as possible.