Introduction:
Basic health indices in India have vastly improved since we became independent in 1947, average life expectancy has increased, infant and maternal mortality rates have improved a lot, but we still have a long way to go before we achieve developed gold. . European standards.
These improvements occurred due to improvement in education, sanitation, healthcare facilities, and increased disposable income, resulting in general improvements in living standards across the board.
Today we are producing more cereals, legumes, fruits, poultry, fish and also consuming more, as a result the availability of protein in our diet has improved a lot, resulting in taller and healthier Indians.
But together with the increase in disposable income and the increase in the standard of living, the consumption of alcohol, tobacco, red meat and fatty foods increases.
The increase in wealth and the affordability of new technological gadgets has made us more sedentary and dependent for even the smallest and easiest job; today we usually use the mobile phone from the comfort of our home to contact the shopkeeper, pharmacist, maid, electrician, mechanic, etc.
And instead of walking to the nearest convenience store, we tend to use a vehicle and instead of walking or biking to get around our neighborhood, we take a motorized vehicle.
Many of us will have trouble remembering the last time we walked the distance to catch an auto rickshaw or taxi. Today we tend to book a taxi and it picks us up at the door of our house.
Which, together with insensitive or indifferent civic management, has resulted in unplanned development in most urban centers where the availability of drinking water, sanitation services are under pressure along with vehicular, industrial, land and augmented and unmanaged acoustics.
In 2012, the GOI together with the Indian Medical Research Council published an updated definition of overweight and revised the figures to:
If the BMI (body mass index) is between 18 and 22.9 kg/m2, the person has a normal weight
If the BMI is 23-24.9 kg/m2, the person is overweight.
If the BMI is greater than 25 kg/m2, the person is OBESE.
In the 21st century, obesity has taken on epidemic proportions in India with more than 5% of the population falling under the definition of OBESITY.
While studying 22 SNPs (single nucleotide polymorphisms) near the MC4-R gene, the scientists identified a SNP 12970134 that is primarily associated with waist circumference. Nearly 2000 people of Indian origin participated in this study and this SNP was found to be more prevalent in this group.
Therefore, we are genetically predisposed to abdominal obesity and this is one of the major morbidity factors behind type 2 diabetes and cardiovascular disease.
Overall, between 3 and 5 million deaths are due to obesity, 3.9% of years of life lost and 3.9% of years lost due to disability-adjusted life years.
All of the above has increased the number of Indians suffering from lifestyle-induced non-communicable diseases like cancers, heart vascular diseases, diabetes, hypertension, mental illnesses, respiratory disorders like asthma, etc.
What is the disease burden of prevalent non-communicable diseases such as cancer, diabetes and cardiovascular diseases in India? (Reference: Background Papers on Burden of Disease in India published by the National Commission on Macroeconomics and Health)
The figures for diabetes, CVD (cardiovascular disease) and cancers are alarming with the highest percentage of new cases reported in urban areas and younger men and women are just as vulnerable as middle-aged men.
Diabetes:
India is projected to become the diabetes capital of the world, it is estimated that in 2015 approximately 4.6 million Indians were diabetic.
The prevalence is estimated as:
In the age group of 30 to 39 years, it is estimated that about 6% of the population is diabetic.
In the age group of 40 to 49 years, it is estimated that around 13% of the population is diabetic.
In the age group over 70 years, it is estimated that about 20% of the population is diabetic.
Diabetes has been recognized as one of the major contributing factors in the increase in the number of patients with cardiovascular disease (CVD) in India.
Cardiovascular disease (CVD):
It is estimated that about 6.4 crore Indians had one or the other condition that can be classified as CVD.
Coronary heart disease is a combination of conditions including acute myocardial infarction, angina pectoris, congestive heart failure (CHF), and inflammatory heart disease.
It is increasing in rural areas and is estimated to affect 13.5% of the rural population in the 60-69 age group.
More and more cases of CVD are being diagnosed among young adults aged 40 years and over.
Cancer:
It is estimated that nearly 10 lakh new cancers were diagnosed in 2016 and 670,000 cancer deaths are expected in 2016.
Worldwide, cancers account for 5.1% of the disease burden and 9% of all deaths; in India, cancers account for 3.3% of the disease burden and 9% of all deaths.
Response of health insurance companies to the increased burden of disease:
Looking at the vast number of people being diagnosed and affected by an increased burden of disease, it is a fact that all of these diseases or conditions are dismissed as pre-existing conditions and the risks are not accepted by any insurance company.
The best response has been the benefit policy of Life insurance companies that offer fixed term plans for cancer or heart disease but to pay the benefit the diagnosis has to be during the policy period.
Survivor benefit plans, popularly known as critical illness benefit policies, pay only when the illness becomes critical, particularly cancer. once the disease reached the third or fourth stage of manifestation.
Currently, the schemes for people diagnosed with or who survive these diseases are minimal. Some insurance companies have tried to launch products that cater to people with pre-existing conditions or survivors, but the effort seems half-hearted.
New India insurance has launched cancer care policies with the Indian Cancer Society and the CPAA, but both policies exclude existing cancer patients or cancer survivors and only enroll people who have no signs of cancer.
Medical insurance policies for patients with cardiovascular diseases:
The Start Health and Allied insurance company has launched the Star Cardiac care policy for people who have undergone PTCA, CABG within a period of 7 years before the start of coverage under this policy.
Some characteristics of the Cardiac Care insurance policy:
There are 2 sections of the policy, section 1 is normal health insurance with PED covered after 48 months, 2% limitation on room, doctor’s fees and nursing charges subject to a maximum of Rs.5000 per day and liability for package fees is limited to 80% of package fees.
But section 2, which covers coverage for known cardiac cases, has no limitation other than YES.
There is a 91-day waiting period before a person can claim for any complications due to a pre-existing heart condition under this policy.
Health insurance plans for people with diabetes:
In the Diabetes space there are two Diabetes safe products from the insurance company Star Health and Allied and the Energy Health insurance plan from the insurance company Apollo Munich Health:
A comparison between the two products is like:
Insurance company: Star Medical Insurance
Product: Diabetes Insurance Insurance Plan
Who is covered?
Patients suffering from type 1 and type 2 diabetes
Number of plans:
2 plans in plan A pre-acceptance medical examination must, in plan B no pre-acceptance medical examination
Waiting period: In plan A no gap, in plan B 15-month gap for disease coverage related to the CV system, disease of the renal system of the eyes and diabetic peripheral vascular disease, foot ulcers
Family float option: available, both plans have coverage of 2 sections one section
benefits under the family float and section 2 are specific to diabetes care.
Sum assured Rs 300,000 to Rs 10,00,000
meIncome tax benefit: Less than 80(D)
Limitation:
For cataracts the limitations are defined as :
For SI 3-500,000 liability at Rs 20,000 per ocular person and Rs 30,000 per policy period
For SI Rs. 10,00000 liability limited to Rs. 30,000 per eye and Rs. 40,000 per policy period
For diseases of the cardiovascular system, the limitation is defined as:
For SI 300,000 liability limited to Rs.200,000
For SI 400,000 Liability limited to Rs.250,000
For SI 500,000 liability is limited to Rs 300,000
For SI 10,000.00 liability limited to Rs.400,000
The cost of artificial limbs is limited to 10% of the SI if the amputation is related to diabetes.
Insurance company: Apollo Munich health insurance company. limited
Product : Energy Health Insurance Plan
Who is covered?
Patients suffering from type 2 diabetes, impaired fasting glucose, impaired glucose tolerance, or hypertension are covered.
Number of plans: Single plane
Waiting period : No waiting period, day 1 hospitalization for diabetes and hypertension
Family float option: No, policy available individually
Sum assured : Rs 200,000 to Rs 10,000,000
Income Tax Benefit : Less than 80 (D)
Limitation: Unlimited
SVA (Value Added Services): Health coach, phone consultation, health line, discounts, access to wellness portal run by HRA, stores medical records
Optional VAS services: diagnostic monitoring program to control and manage health).
Awards: Premium discounts and additional benefits for good health management