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Health Insurance Scheme Generates Conflicting Opinions

An insurance scheme which has received the approval of the Government is attracting brickbats and bouquets. As many as 2.5 million households stand to benefit from the scheme which the ICICI-Lombard is // meant to implement. But the scheme has come under criticism from some experts who contend that it will do no good to the poor while undermining the reasonably successful public healthcare system in the state.

Every year all households coming under the project can avail themselves of a maximum Rs.5,000 as outpatient expenses, Rs.30,000 for treatment in hospitals, and Rs.15,000 as hospital expenditure for every birth in a family.

The annual premium per family works out to Rs.399. But each family has to pay just Rs.33. The rest will come from the central and state governments and local bodies. Leading public health expert C.R. Soman said that the scheme was practically not feasible.

"It is sad our leaders fall prey to the tactics of companies promising the sky," he said. "The private health sector will take away most patients. The public healthcare sector will suffer. This is the desire of those behind the scheme."

B. Iqbal, a health educationist and a former vice-chancellor of the University of Kerala, said the scheme violated the basic principles of insurance. "The general practice in insurance is to share the risk. Under this scheme, the risk is very high for the company. There is a catch somewhere and only time will where that lies," said Iqbal, who is also a neurosurgeon.

But T.K. Jose, convenor of the official committee that formulated the program, said both the company and the Kerala Government were aware that the first year could see the company in the red. He also said that ICICI-Lombard had come up with the lowest premium quotations.

"We are confident the scheme will be viable because quotations from all nationalized insurance companies were high. The lowest rate from the public
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