Health Insurance Coverage for the Times : Harmala's CanSupport ...

Posted by admin on Mar - 26 - 2013

Health insurance is a vexing thing. If you don?t have it, you face the risk of spending huge amounts out of your own pocket to meet any medical contingency, while if you have it, you are never quite sure if those treating you are responding more by your symptoms than to the medical coverage you have. This again is the result of a system that does not offer universal health coverage to its citizens across the board and where a growing number of health providers today are private players. There is also much to be said for adapting health insurance schemes to meet the challenge of a changing health landscape.

For those of us who work in palliative care, the need is for medical coverage schemes that reimburse those with life limiting diseases and conditions. The increase in the life span of Indians is already seeing a commensurate rise in the incidence of non-communicable diseases like heart disease, diabetes and cancer as well as debilitating conditions associated with old age such as osteoporosis, Alzheimer?s and dementia. As we live longer and longer it is these conditions that are going to dictate the quality of our final days.

The evidence available from the west, and from Japan where people are living the longest, suggests that for most of us the last years of life are going to be fairly miserable unless we and our caregivers are able to access care that provides relief from unpleasant symptoms, responds to our nursing needs and offers psycho-social support. As we have been able to show from our many years of experience of running a home care service at CanSupport, this is not expensive or high tech care nor is it necessary to hospitalize people to deliver it. In fact, we encourage people to stay at home as this is where most of them are most comfortable, there is usually a member of the family willing to act as chief carer, besides which this is cost effective care. The unfortunate part is that this kind of care is not covered by most insurance companies who only reimburse hospital stays and in-patient procedures. As a result we have an ironic situation where even when treatments can be given on an out-patient basis patients are advised to check in.

Such discriminatory practices only help the hospitals and the insurance companies. Not only is insurance dictating where you should receive treatment but also who should receive treatment. Those who are elderly and above the age of 70 years are excluded from most medical coverage policies. How ironic and out of step this is with the reality of our lives today when more and more of us are likely to live beyond seventy years! Insurance companies would do well to cover this population for palliative care outside the hospital setting so that families as well as the state are spared the cost of inappropriate and expensive procedures and treatments that add unnecessarily to the burden of care and compromise quality of life. Surely, it is not a question of just prolonging life but of ensuring its continuing value?

Source: http://www.cansupport.org/blog/?p=104

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