Karna health insurance scheme could be model for whole India:

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The Centre could draw on the success of a Karnataka health insurance scheme as it gets ready with its Universal Health Assurance Mission which seeks to cover all Indians and provide medicare free to the poor, the World Bank said today.

A World Bank-funded study of Vajpayee Arogyashree Scheme, which provided tertiary care free to the poor in the state, showed the risk of dying from conditions covered by the insurance fell by 65 percent and out-of-pocket expenses for hospitalisation dropped by 60 percent.

The study’s lead author Neeraj Sood told reporters that one of the lessons the central government should learn is that it should make sure that doctors and hospitals get enough reimbursement and incentives to take part in the insurance scheme.

There should also be enough checks and balances for reducing “inappropriate” care by way of a robust preauthorisation process, he said.

Expounding on the benefits of a government-sponsored insurance scheme, Sood said one life under VAS was saved for a cost of around 2000 US dollar against 50,000 US dollar it cost in a developed country like USA.

The mortality rate among people less than 60 years of age fell to 50 percent in notheren Karnataka, which was coevered under the scheme first, against 70 percent in areas not covered. The scheme has now been expanded to the whole state.

The state’s Health Minister U T Khader said the government spent only Rs 212 per family per year under the scheme, which was nothing compared to benefits it provided.

“We will now be covering people above poverty line (APL) as well as we saw that many APL families were reduced to BPL status after paying hefty bills of private hospitals,” he said in a lighter vein.

“The results of this study are important to India as it makes choices in how to make progress towards universal health coverage,” said Onno Ruhl, World Bank Group Country Director for India.

The study included more than 82,000 households.

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