Insurance is a method of spreading over many persons a possible financial loss
serious about being conveniently borne by the individual. The essential elements
of the Insurance are to shift the burden of damage to a willing and capable loss
bearer when considering a comparatively small contribution called the premium.
So, In simple terms, Insurance is a process whereby the risk of financial loss
arising by the death or disability of a person or damage, deterioration,
destruction, or loss of property owing to some serious danger to which they are
exposed is assumed or taken by another.
Life is unpredictable, and you should always be ready to face the
unpredictability of things happened. We should not depend on the chance that
anything will just happen in our favor. So, for unpredictable situations, there
was an introduction to the Health Insurance Policy. Medical security can help to
deal with all the costs that occurred in unpredictable conditions to protect
your family.
Health Insurance policy was brought up to cover the insured person's medical
costs in the case of hospitalization and or critical illness.
In concern to the health insurance policy, there is a policy called Yashaswini Health
Insurance Policy. This policy or scheme is a cooperative farmer's health care
scheme that offers health insurance coverage to tenant farmers or peasants who
are members of cooperative societies in Karnataka.
This scheme covers around 803 surgical procedures. The person or workers with
lower-middle-income and middle-income groups can avail of this scheme. Any
peasant in Karnataka can avail of this scheme provided that he or she is a
member of any cooperative society.
At first, it was not a Government scheme, but later, when government
participation was involved, there were several benefits like:
- Government provided access to cooperative societies, which was the key.
- The department of cooperative administrative agency provided a vehicle
through which the scheme could be popularized, and communicated to rural
farmers.
- By all the popularization of government, people considered it as a
Government scheme although it was private self- financed Insurance.
- People were happy that they could go to a private hospital for treatment
via a government-backed scheme, which they were unable to afford earlier.
This scheme has faced a lot of problems in establishing its motive. But in its
second year, it covers 2.2 million farmers and peasants who pay an annual
premium of Rs. 60 ($ 1.50) for comprehensive coverage of all surgical
procedures. The scheme is unique as it has overcome many of the problems
associated with health insurance schemes for the poor.
The Yashaswini health insurance policy: Overview
The Yashaswini Health Insurance Policy was launched by the former chief minister
of Karnataka S.M. Krishna on November 14th,2002. The Yashaswini Health care
scheme became operational in 2003, and available to cooperative farmers via
network hospital spread across the state of Karnataka.
There is a trust of the Yashaswini cooperative farmers' health care scheme,
which is registered under The Indian Trust Act 1882. The Yashaswini health care
trust was established to ensure efficient implementation of the yashaswini
health insurance scheme. The chief patron, who is the minister of the
cooperation is the chief minister of Karnataka. It is essential to note that the
state government contributes to the trust.
The governing body also consists of five renowned doctors across the state as:
- Chairperson of the trust was:- Principal secretary, cooperation
department, the government of Karnataka.
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- Senior officers:- Managing director, Karnataka State Cooperative Apex
Bank Ltd, Bangalore Registrar of Cooperative Societies, Bangalore
Commissioner for Cane Development, and Director of Sugar, Bangalore Managing
Director Karnataka State Cooperative Milk Producers Federation Ltd.
Bangalore Additional. Registrar of Cooperative Societies, Bangalore.
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- List of Doctors:- Dr.L.H.Bidri, Bidri's Ashwini Hospital, Bijapur & Trustee
Dr. Manjunath Shetty, Head of Nephrology Department, J.S.S College, Mysore Dr.
Chandra Mouli, MBBS, M.S, Consultant Surgeon, Fortis Hospital, Bangalore Dr. Deviprasad Shetty,
Narayana Hrudayalaya, Bangalore Dr. C.N. Manjunath Director, Jayadeva Institute
of Cardiology, Bangalore.
No. Of Network Hospitals:
There is a wide range of hospitals under this scheme as there are around 572
network hospitals under the yashaswini cooperative farmers' health care scheme.
Coverage under the Insurance Scheme:
The Yashaswini Health care scheme provides health insurance coverage to Indian
Farmers or tenant farmers across 30 districts in the state of Karnataka. The
scheme has around30 lakh beneficiaries. Around 803 surgical procedures are
present in the scheme, which are:
- Cardiac and Cardiothoracic surgery
- General Surgery
- Orthopedic Surgeries
- Neurosurgery
- Vascular Surgery
- Snake Bite
- Surgical Gastroenterology, etc.
Exclusions under the Yashaswini scheme:
Few ailments are excluded from this scheme provided to the Indian farmers and
peasants. Some of them are:
- Diagnostic Investigations
- Burns Cases
- Chemotherapy
- Prosthesis
- Follow-up treatment
- Dialysis
- Dental Surgeries
- Skin Grafting, etc
Evolution of the Scheme:
The Rural Health Care Scheme was first brought up by Dr. Devi Prasad Shetty, a
Cardiac Surgeon who pioneered the spread of telemedicine and low-cost cardiac
operations in India. He was acutely concerned with the problems of access to
sophisticated health care of the rural population. He attempted to solve this
problem through the telemedicine, using local providers and doctors in urban
hospitals connected via the internet.
At that time, it was just the experimental stages in several Indian Hospitals,
and this made it clear that the poor were not able to afford the medical care,
which further leads him to an option of the Insurance. For the benefit of the
Indian farmers and rural population, this self-financed health Insurance scheme
for rural poor should have low premiums. Still, at the same, it should provide
benefits for surgical procedures and hospitalization expenses, as well as cover
all the costs associated with the procedure.
In Dr. Shetty's mind, the solution was to create an extensive Health Insurance
Scheme. The basic design of the scheme was that the law of large numbers would
overcome the fundamental financing problem associated with the small schemes or
projects of the past.
Chief Minister S.M. Krishna launched the scheme, but the concept was laid by
Narayana Hrudayalaya's Dr. Devi Prasad Shetty in Bangalore. It is a self- funded
health scheme. Karnataka's cooperative farmers are given quality and
cost-effective health care facilities through the yashaswini health care scheme
in-network hospitals.
After Dr. Shetty laid down the principal fact for such a scheme, with some
modifications, Sri A Ramaswamy further brought the scheme, a former Principal
Secretary to the Karnataka government and the cooperation Department.
Features of the Scheme:
The Yashaswini scheme is applicable for the members of the Karnataka Rural
Co-operative Society.
There are some salient features of yashaswini health insurance scheme:
- The primary member of the family, who is the part of the rural
Co-operative Society, can benefit from the scheme's benefits.
- The scheme begins from June 1st and ends on May 31st of the next year.
- Each enrollment period fro the scheme starts from July to October every
year.
- Members of Self-helps groups and many other groups are eligible in this
scheme like weavers, fisherman cooperative societies, financial transactions
with cooperative society, or banks are eligible for the scheme.
- For every new year, the person enrolled in this scheme must pay a fixed
amount of annual contribution. For FY 2017-18, Rs. 300 is the member
contribution for Rural Yashaswini and Urban Yashaswini; it is Rs. 710.
Medical Benefits:
There are many medical benefits of the yashaswini health insurance scheme-
- Surgical procedures of 823 types specified by the yashaswini trust covered
under the scheme at rates pre-negotiated with the partner hospitals.
- The scheme covers Medical emergencies like a snake bite, dog bite, bull
gore injuries, electric shocks, accidents, and drowning occurring when using
agricultural implements.
- The scheme even covers Normal delivery, angioplasty procedures, and
neonatal care.
Conclusion
So the essential step of all such efforts is to provide a high degree of health
security to the most impoverished populations of the world. The key motive was
to introduce the exiting organizations that would connect people to health
security ideas. It helps in collaborating with the people who are geographically
separated.
There should be a methodology by which the subscriptions can be collected from
poor people from dispersed rural and informal sectors to enroll the people in
the system. This scheme provides the state with a Health Care Backbone, a system
that attracts patients and provides hospitals. One suggestion made by Dr. Shetty
is to link the education and collection of premiums to the post offices, perhaps
the most decentralized government institution in India.
This scheme was to provide Health and Security in no small section of people. It
is an instance where India's large population, generally seen as a negative, can
be a valuable resource increasing social health. Further, it can be said that
70% of the world's population doesn't have health security; the introduction of
such schemes was required to provide protection. Future research needs to
continue studying variants of this scheme.
In sum, significant individuals like Dr. Shetty, a responsive state department,
the identification of organizations that unite widely dispersed rural
populations, the network of private hospitals, and the department of
cooperatives' energy were crucial aspects in establishing a scheme of this
magnitude. The issue of free choice and whether more comprehensive coverage can
is affordable or not are the two major issues to be considered for the future.
Written By: Riya Jain
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