Health insurance is the most effective and conventional way by which people collectively pool their risk of incurring medical expenses. By estimating the overall risk of healthcare expenses, a routine finance structure in a form of monthly premium or annual tax is developed, ensuring that money is available to pay for the healthcare benefits specified in the insurance agreement. The benefit is administered by a central organisation such as a government agency, private business, or even a not-for-profit entity. Recently the US Healthcare reform bill secured by Obama administration has given all reasons for exhilaration to the American population in particular and the healthcare community in general, across the globe.
In India health insurance was introduced in 1912, when the first insurance act was passed and witnessed little change until 1972, when the insurance industry was nationalised and 107 insurance companies were brought under the umbrella of the General Insurance Corporation (GIC). Further, in 1999 the enactment of Insurance Regulatory Development Act (IRDA) took place, which allowed private and foreign entrepreneurs to enter the insurance market in the country. The recently launched Rashtriya Swasthya Bima Yojana (RSBY) has empowered the BPL population with the ability to avail quality healthcare services free of cost. Within a span of two and a half years, the scheme has provided healthcare cover to almost 70 million people living under the poverty line.
The September issue of eHEALTH focusses on the health insurance sector in India with a thrust on claims processing management. It has a cover story on the in-depth analysis of the health insurance sector in India. Besides, the interview of Anil Swarup, Director General, Labour Welfare, Ministry of Labour and Employment, Government of India, the man behind RSBY, has been featured to take a watch at the government policy level. The article ‘Stake a claim’ is apt with the focus of the issue depicting that it is the time for ‘Integrating clinical logic into claim processing systems.’
We also find it our pleasure to present the collage of eINDIA 2010 held during 4-6 August in Hyderabad, which has a detailed event report along with the album of the award winers in different categories. Let’s take a look!