Tamilnadu Chief Minister's Comprehensive Health Insurance Scheme

Wednesday 2 November 2016

Latest Life Insurance Awareness Survey

Insurance Awareness Survey 

Insurance Regulatory and Development Authority (IRDA) engaged the National Council of Applied Economic Research (NCAER) to carry out a pan-India survey to assess the levels of insurance awareness in the country. The survey was undertaken in 29 states/union territories.

The survey has brought out various findings from the information it gathered relating to the socio-economic profiles of the insured and the uninsured in both rural and urban areas and correlating it to various life and general insurance parameters. The survey shows that most of the insured are salaried, regular wage earners or self-employed.  Insured households possess a high level of education as opposed to uninsured households which are mostly illiterate.
  • Geographic Analysis: The report contains a geographical analysis of the parameters and it is interesting to study the patterns in various states. (this requires more info from the survey or we can drop it in this position)
  • Purpose of insurance: A higher percentage of insured households, as compared to uninsured households, are aware that the purpose of insurance is to compensate for losses due to unforeseen events.
  • Source of Information: The major source of any information for both the insured and uninsured is television. But when it comes to insurance the major source is insurance agents.
  • Of the insured households 97% feel that insurance is relevant for them. Even among the uninsured, 57% feel that insurance is relevant for them.
  • Relevance of Insurance: The fear of accidents and untimely death makes them think of insurance.  Among those who did not think that insurance is relevant, the attitude is that they would rather enjoy the present than think of securing the future. There is a general feeling that insurance simply takes away hard-earned money.
  • Perceptions of Insurance: More than half of the insured households think that insurance is both a savings and a protection tool.
  • Decision to take insurance: The decision is majorly influenced by agents, friends and relatives. There are certain regional variations as to whose influence predominates and this is brought out in the report.
  • Life and Non-life Insurance: For purposes of identifying the universe of insured, the survey considered those who held life insurance. Among them, it was noted that only 31% had motor insurance and 6% health insurance.

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Tuesday 1 November 2016

Chief Minister's Comprehensive Health Insurance Scheme - Increasing Access

Increasing Access

Introduction

To increase access for tribals, women and the general population who do not have access to essential and life saving services, TNHSP has conceived and implements the following programmes:

Tribal Healthcare

Tribal communities constitute less than one per cent of the total population in the State (population around 6.25 lakh). These communities are spread throughout the State, but there is a higher concentration in 12 districts which are referred to as the Tribal districts.
Historically, tribal communities in Tamil Nadu have not enjoyed adequate healthcare services. Inaccessibility and cultural factors are some of the reasons for this. Tribal communities are spread both in the plains and hilly terrain, and communities located in remote areas pose a challenge when it comes to providing healthcare services.
Thus, one of the goals of the TNHSP is to create better access for the state's tribal populations to healthcare.

Comprehensive Emergency Obstetric and New born Care services (CEmONC)

Analysis of the maternal and infant mortality data revealed that 75% of maternal deaths occured during intra partum (during delivery) and post partum (just after delivery) and 25% occured in ante partum (before childbirth).
One common issue was that of referral. When the hospital where the pregnant woman accessed for care did not have adequate facilities, she had to be referred to another hospital elsewhere. Covering the distance between two hospitals at such a critical stage could prove fatal, as it was usually the complicated cases that were referred to other hospitals especially in the rural areas. Hence, it was decided to strengthen the obstetric and new born services in the hospitals which led to the creation of the ‘Comprehensive Emergency Obstetric and Neonatal Care’ Centres.

Chief Minister's Comprehensive Health Insurance Scheme

Quality healthcare which comes at a cost, many a time turns out to be an unbearable burden for the economically weaker sections of the society. One way to address this is to provide free healthcare in Government hospitals. But what about treatments and diseases not feasible in district and sub-district hospitals and also the long waitlisted situations for emergency and life saving surgeries due to pile up of cases? How to ensure that economically weaker sections are not deprived of required healthcare?
For addresing this situation the Government of Tamilnadu introduced a massive welfare scheme called “Chief Minister Kalaignar Insurance Scheme for life saving treatments” on 23rd July 2009, for the poorest of the poor/low income/unorganised groups who cannot afford costly treatment, as a supplementary facility for getting free treatment in empanelled Government and private hospitals for such serious ailments.
On January 11, 2012, the Chief Minister's Comprehensive Health Insurance Scheme was introduced. Under the scheme, the sum assured for each family would be Rs.1 lakh every year for a total period of four years and for a total value of Rs. 4 lakh. In the case of certain procedures, the ceiling would be raised to Rs.1.5 lakh per annum. No fewer than 250 hospitals would be empanelled under the scheme. At least six hospitals in each district would be covered. There would be more hospitals in cities such as Chennai, Coimbatore and Madurai.
The new scheme would cover 1,016 procedures, 113 follow up procedures and 23 diagnostic procedures. The cost of tests required for treatment would also be part of the insurance cover.
 

Poison Treatment Centres

As it was found that there were many incidences of snake bites, organo phosphorous compound poisoning cases in the state and resultant high death rates it was decided to establish poison treatment centers throughout the State. Totally, 34 Poison treatment centres were established in 29 district headquarters hospitals and 5 taluk hospitals.

Effective Health Care Services in Tamilnadu - The Tamil Nadu Health Systems Project

project Overview

Tamil Nadu is ranked among the high-performing States in India, in the area of human development. The State is noted for its low mortality rates and effective healthcare services. The State has a long track record of innovations in the health sector. It has pioneered many new approaches to enhance effective access to quality health care at low financial costs. Over the last few decades, healthcare in the state of Tamil Nadu has improved significantly, with more people having increased access to medical care. There is a strong commitment to high performance in the health sector.
Despite the speedy progress and development, the State continues to face challenges in the healthcare sector that need to be dealt with in a phased and systematic manner. The broad areas that need addressing are
  • Coping with non-communicable diseases (NCD)
  • Providing the highest quality of healthcare 
  • Resolving equity-related issues
  • Having an effective health financing system

Health Policy of 2003 

To tackle these challenges, the Government of Tamil Nadu developed a Health Policy in 2003. The Health Policy aims to address key health challenges, combat non-communicable diseases and accidents, strengthen management of health systems and increase effectiveness of public sector healthcare services. The policy focusses on improving the health status of the general population, with special emphasis on low-income, disadvantaged and tribal communities, over the next two decades.  

The Tamil Nadu Health Systems Project 

 The Tamil Nadu Health Systems Project (TNHSP), implemented by the Health and Family Welfare Department (Government of Tamilnadu), lends its support to the Health Policy of 2003 and focusses on improving the health status of people belonging to the lower socio-economic strata. New approaches to address non-communicable diseases, addressing the health needs of the tribals and partnerships with the NGOs form the core of this project. The Tamil Nadu Health Systems Project will assist in fulfilling the aims of the Health Policy through the following interventions  
  • Increased access of health services for poor, disadvantaged, and tribal groups
  • Developing effective interventions to address key health challenges 
  • Improving health outcomes and quality of service by strengthening management of the public sector health systems and by involving the non governmental sector
  • Increasing the effectiveness and efficiency of the public sector hospital services at the district and sub-district levels
The TNHSP is structured on the following themes:
  • Child health
  • Indigenous peoples
  • Health system performance
  • Population and reproductive health
  • Injuries and non-communicable diseases

The World Bank and TNHSP 

In 2005, the World Bank approved the Tamil Nadu Health Systems Project for a total cost of Rs. 597.15 crores. The World Bank’s involvement in the project has been extremely advantageous. It has helped in introducing new approaches in the way the health sector functions in the State. While the health system in Tamil Nadu has been fairly effective in providing basic health needs to its people, it is expected that the goals sought in the project will demonstrate the impact of cutting-edge reforms.
Among other goals, the TNHSP addresses two MIllenium Development Goals (MDG), namely reducing child mortality and improving maternal health.

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Chief Minister's Comprehensive Health Insurance Scheme

Introduction

Quality healthcare comes at a cost that is unaffordable for the economically weaker sections of society. One way to address this is to provide free healthcare in Government hospitals. But sometimes treatment is not possible at district and sub-district hospitals. Furthermore, the demand for advanced healthcare leads to long waitlists for emergency and life saving surgeries. To address these challenges and ensure availability of advanced healthcare, the Government of Tamilnadu introduced a scheme called the “Chief Minister Kalaignar Insurance Scheme for life saving treatments” on 23rd July 2009. This scheme is for the poorest of the poor/low income/unorganised groups who cannot afford costly treatment, as a supplementary facility for getting free treatment in empanelled Government and private hospitals for such serious ailments.

Chief Minister's Comprehensive Health Insurance Scheme

On January 11, 2012, the Chief Minister's Comprehensive Health Insurance Scheme aimed at benefiting 1.34 crore families was launched.

Eligibility

Any family whose annual income is Rs.72,000/- or less, members of unorganised labour welfare boards, and the spouse, children and dependent parents of such members in urban and rural areas are eligible. All Government servants, civil pensioners, ESI beneficiaries and families having an annual income of more than Rs. 72,000 /- but not members of any unorganised sectors welfare boards are not eligible under this scheme.

Needs Covered

Under the scheme, the sum assured for each family would be Rs.1 lakh every year for a total period of four years and for a total value of Rs. 4 lakh. In the case of certain procedures, the ceiling would be raised to Rs.1.5 lakh per annum. No fewer than 250 hospitals would be empanelled under the scheme. At least six hospitals in each district would be covered. There would be more hospitals in cities such as Chennai, Coimbatore and Madurai.
The scheme would cover 1,016 procedures, 113 follow up procedures and 23 diagnostic procedures. The cost of tests required for treatment would also be part of the insurance cover.
 
For more details, please visit http://www.cmchistn.com/

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