Cost of insurance-based funding
Context:
- The Tamil Nadu public health model is iconic, It has ensured equity in the delivery of health care, led to big improvements in maternal and infant mortality and universal immunization coverage, and led to a low total fertility rate compared to the all-India average.
Points to Ponder:
- Tamil Nadu has an insurance-based model where the people are given insurance sponsored by both state and Central government which will reduce the burden on common men.
- There are 19,866 doctors, 38,027 nursing staff, 60,181 supporting healthcare workers, and 97,000 beds spread across 38 medical colleges, 18 district hospitals, 278 sub-taluk hospitals, 2,286 primary health centers (PHCs), 462 upgraded PHCs, and 8,713 health sub-centers in the public health sector. These facilities serve 5,76,174 outpatients per day and 2,15,35,000 patient bed days per year.
- In the last decade, there has been a shift in hospital financing. The financing balance ranges from National Health Mission funds to the Chief Minister’s Comprehensive Health Insurance Scheme. (CMCHIS).
- One of the main benefits of this approach is decentralization, which enables individual departments to prioritize their needs and make quick medical choices based on evidence-based medical advancement. This helped in removing a lot of red tapes.
Negative outcomes:
- Each department in the medical college has become its entity, and these departments have begun competing with one another based on maximum profit and loss.
- Administrative delays in insurance companies have caused a shift in the focus of hospitals from patient care, treatment, and research to claiming money from these companies.
- The hiring of 6,000 nursing staff and 9,800 allied health workers as temporary employees with low compensation has slashed the workforce. There are now two categories: a stable high-paid class and a transient low-paid class.
