Hello Sir/Madam,
This is Dr Shashi. I have been practicing as a general practitioner since 12 yrs. I have done my graduation in medicine from Mumbai University. I did my Masters in Social Work from Tata Institute of Social Sciences, Mumbai. Furthermore, I have completed my PG in Healh Insurance from III (Insurance Institute of India).
My understanding of the current health sector is that many people are facing poverty because of the growing health cost. A study has revealed that the Loans taken for non-productive purpose is greatest for meeting health needs.
Also the present Health delivery structure is such that insurance (Health), which is an important component of financial assurance is finding it difficult to sustain.
I have designed a health concept which has provisions for addressing many of the shortcomings of the current health sector.
The need for a new idea is the flaws in the existing Mediclaim Insurance structure which are:
- High premium rates, hence available to limited people.
- There is no benefit for the premium payers who don’t get ill.
- Limited illness coverage.
- It is a problem when the cost exceeds the coverage.
- No/Limited benefits for OPD treatment.
- No/Limited benefits for diagnostic procedures when not hospitalized.
- No monitoring of health when person is not ill. Care taken only when person is hospitalized.
- Service limited to treatment. No health awareness initiatives.
- Malpractices across the service providers and the beneficiaries.
- No direct contact of the service provider and the beneficiaries. Purely professional relationship.
- No Importance/Coverage given to alternative treatment of medicine. So no choice of treatment for patient.
There are many more reasons, but I have felt these as some important ones.
Characteristics of the concept:
- Forming chain of clinics. We can start with a minimum number of clinics at the initial stage, but this concept has the potential to be replicated in every part of the country.
- Giving healthcare insurance at the general practitioner level where we can guide the health of the people to the very end.
- Charging a minimum amount as monthly/quarterly/yearly premium and giving service for the entire family (just like the prepaid mobile service).
- The service will include free mandatory health checkups, monthly health awareness camps (Cardiac care, Liver care, Kidney care, ophthalmic care, Skin care and many others).
- Collecting/Preserving data of patient’s health history, hospitalization at concessional rates, integration of different streams of practices, free ambulance service, benefits for the physically challenged/aged.
- Different services for different target group of people- Tailor made, (economical/social). This will meet the needs of every group of people.
- Has the potential to reach out to the rural population at a much lower rate.
These are just some of the services that we will be providing. There are a whole lot of things which are considered and that too at a very reasonable charge.
The main benefits of this concept are:
- Being a prepaid service, families will not hesitate to visit a doctor in times of crunch. There are times in a month when families are reluctant to go to a doctor even if they are in dire need because of the money part. The primary sufferer of these are females/aged/ and the physically challenged. Having said that it does not mean that the concept is only for the lower strata of the society. The concept has provisions which will open it up to the upper middle class people also. Hence this concept has the potential to reach out to each and every section of the society.
Also this concept will help patients who require regular Healthcare monitoring (B.P., Sugar etc) and other care which have to be regularly monitored but are not because of the cost attached to the doctors’ visit.
- The concept will be emphasizing on the preventive aspect of healthcare and not just curative aspect. This will help in early detection and treatment.
- The mandatory health checkups will ensure early diagnosis of the illness/disease.
- The mostly neglected/ignored group i.e. the physically challenged, aged, females, will benefit most from this system.
- Integration of various system of practice will give a choice of treatment to the patient.
- Special consideration given to mental and social well-being.
- Concessional hospitalization will ensure that a medical emergency wont drive a family into unwanted debt/financial crisis.
- We can replicate this concept in the rural areas at a much lower cost which will benefit the rural population
- This system will be a reference platform for any MEDICLAIM POLICY PROVIDER/HEALTH INSURANCE COMPANY. Many times patients go to tertiary care hospitals for simple ailments/procedures which add to the treatment cost to the Insurance Company. But our clinics will be a proper source which will guide patients to proceed to the appropriate hospitals for necessary treatment. This will save a huge lot of money to the insurance company. Also this service can be given as an add-on to the existing INSURANCE/MEDICLAIM policies.
This service can also function as a TPA Service for the insurance companies minus the malpractices.
There are many more things which can be achieved through this service, but the real achievement of this concept is that it will provide HOLISTIC HEALTH to the masses and the true sense of HEALTHCARE can be achieved.
I have prepared a detailed plan of the concept including the financial aspect.
I am looking out for partners who share my concern and also wish to do business through a noble profession
Thanking you,
Regards,
Dr. Shashi.