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PROJECT ASSIGNMENT
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Submitted to: MRS. SANGEETA CHANDA FACULTY INSURANCE LAW Submitted by: MANASI AGARWAL Roll No- 428 8TH SEMESTER, 4TH YEAR
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Secondly, I would like to extend my sincere acknowledgement towards the Librarian of CNLU, for making all the reading materials available relevant for my Research Paper, within such short notice. In fact the CNLU Library came up as an excellent source for all the requisite data.
Thirdly, I would like to thank the Managing staff of CNLU, for providing me with the facility of 24 hours/ 7 days a week Internet connection, since the search engines namely, www.google.com, www.bing.com, where an indispensable need to facilitate data access within fractions of seconds.
Method of Research: The researcher has adopted a doctrinal as well as non doctrinal method of research. The researcher has made extensive use of the library at the Chanakya National Law University and also the internet sources as well as interacted with the general mass of society. Scope and Limitations The project offers a comprehensive study of the HEALTH INSURANCE IN INDIA. The research paper does not provide a complete understanding of the all the provisions of Health Insurance. Chapterisation I have divided the project into various chapters. Each dealing with different aspects of the topic. In the initial chapters, I have discussed elaborately, the meaning of Health Insurance. Further, I have elaborate different provisions and lastly; I have concluded the topic by summarizing the highlighting aspects of the Health Insurance in India. Sources of Information The researcher has relied on secondary sources for the purposes of this project such as books, articles. Style of writing The researcher has adopted a descriptive and analytical style of writing for the purposes of this research paper. Mode of citation A uniform mode of citation has been followed throughout the course of this project.
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INTRODUCTION BRIEF HISTORY OF HEALTH INSURANCE DEFINATION OF HEALTH INSURANCE HEALTH EXPENDITURE OVERVIEW OF DIFFERENT COUNTRIES HEALTH INSURANCE SCENARIO IN INDIA HEALTH INSURANCE FOR SENIOR CITIZENS HEALTH INSURANCE LAWS AND GUIDELINES IN INDIA CONCLUSION BIBLIOGRAPHY
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Introduction
When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied. Herophilus It sums up the importance of good health. No nation could progress without its citizen being healthy. But, ever increasing medical cost has made health care a distant dream. People are forced to pay out of their pocket and sometimes due to lack of proper financial assistance even suffer death or serious health hazard, bringing their or their closed ones life to a still. In India, particularly such sight is very common. People do not have adequate economic capacity to avail hi-tech medical facility because of the expensive medical procedure. Every poor/middle class/upper middle class in their life time faces such contingencies were his or his loved one life is at risk and require medical attention but due to lack of financial resources they are not able to help them, in such a situation Health Insurance serves as a boon. Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care and health system expenses, among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity. According to theHealth Insurance Association of America, health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury. Includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment"
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Allen D. Spiegel, Hammurabi's Managed Health Care Circa 1700 B.C. available at http://www.managedcaremag.com/archives/9705/9705.hammurabi.shtml (last accessed on 15th February, 2014) 2 See New world Encylopedia, available at www.newworldencyclopedia.org/entry/Health (last accessed on 15th February, 2014)
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The History of Health Insurance in the United States of America. available at http://www.neurosurgical.com/medical_history_and_ethics/history/history_of_health_insurance.htm (last accessed 15th February, 2014)
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Lawrence F. Wolper, Health Care Administration- Managing Organized Delivery System, 5th Edition, Jones and Barlett Publishers International, 12th April, 2010 5 ibid 6 See National Assistance Act 1948 (1948 CHAPTER 29) available at http://www.legislation.gov.uk/ukpga/Geo6/11-12/29/enacted (last accessed 15th February, 2014)
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Pablo Enrique Gottret & George Schieber, Health Financing Revisted; A practioners Guide (World Bank, 2006) 8 See Section 2 (9) of Indian Insurance Act, 1938
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Health expenditure
Health expenditure means health and health related expenditure. Public health expenditure consists of recurrent and capital spending from government (central and local) budgets, external borrowings and grants (including donations from international agencies and nongovernmental organizations), and social (or compulsory) health insurance funds. It is the sum of public and private health expenditure. It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation.9 Health-related expenditures include expenditures on health-related functions such as medical education and training, and research and development.10In United States of America total per capita health expenditure amounts to $8,402 (as per 2010).11 The Health expenditure; total (% of GDP) in India was last reported at 4.05 in 2010, according to a World Bank report published in 2012.12 Now we can see that health care expenditure generally involves two parties either the Public or Private. Public expenditure generally draws funds from the tax i.e. using central or states revenue for health which is enshrined in Part IV of the Indian Constitution. It is the duty of the state to take care of the health of its people. Private expense on the health care in India is generally meted out of pocket i.e. payments to health care providers for services, sometimes donations are also channelized and the other mode is Private Health Insurance. It is the premium contributions towards the health support and health insurance provides pool for future health care. Most
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India - Health expenditure Health expenditure, private (% of GDP) available http://www.indexmundi.com/facts/india/health-expenditure (Last accessed 16 February, 2014) 10 Definition of Health Expenditure available at http://www.fhb.gov.hk/statistics/download/dha/en/c_definition_0405.pdf (Last accessed on December, 2013) 11 Centre for Disease control and Prevention available at http://www.cdc.gov/nchs/fastats/hexpense.html (last accessed on 16 February, 2014) 12 Health Expenditure; Total (% Of GDP) in India
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See http://www.nhsdirect.nhs.uk/About
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Expat guide to Australia: Health Care, The Telegraph, 21 July, 2013 available at http://www.telegraph.co.uk/health/expathealth/7898820/Expat-guide-to-Australia-health-care.html (last accessed on 18 February, 2014)
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Centers for Disease Control and Prevention. CDC.gov (2011-03-06). Retrieved on 2011-10-26. Torio CM, Andrews RM. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011. HCUP Statistical Brief #160. Agency for Healthcare Research and Quality, Rockville, MD. August 2013 17 U.S. Census Bureau 18 Source IRDA and annual report of Apollo Hospital and Max India for 2012-2013.
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See http://www.who.int/countries/ind/en/
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Guidelines on Standardization in Health Insurance, available at http://www.policyholder.gov.in/uploads/CEDocuments/Guidelines%20on%20Standardization%20in%20Health %20Insurance.pdf (Last accessed on 20th February, 2014)
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Anirudh Laskar ,Irda issues guidelines to standardize health insurance, Live Mint and The Wall Street Journal, 21 February, 2013
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