AIDS patients to get health insurance

[Guest guest]

AIDS patients to get health insurance

Archana Patni

Friday, April 7, 2006 (Bangalore):

For the first time in the country, an effort is being made to

provide health insurance for HIV positive patients to finance their

treatment.

It is an uphill task for these patients, especially those who belong

to the economically weaker sections, to fund their treatment. Very

often, lack of treatment leads to premature deaths.

Tough life

For 28-year-old Radha (name changed), life has been extremely

difficult. Married eight years ago, she was infected by her husband

who had AIDS. Her husband died just two years after their wedding.

She was then forced to leave her house and now lives in a home

funded by an NGO. If she manages to get insurance for treatment, she

will get a fresh lease of life.

" This is the first time someone has come up with an insurance policy

for people suffering from AIDS. It will help us a great deal, " says

Radha.

The project, which has an estimated cost of Rs 40 lakh, will be

launched as a pilot project for two years.

It will be first tested in Karnataka and Chennai before expanding to

more areas in the country. The project will also be partly sponsored

by the National Insurance Company.

• Insurance for people below the poverty line will be provided

free of cost.

• The cost of this will be borne by the Government of India

and NGOs working with HIV positive people.

• Four economic slabs will be created and the patients will

have to pay for their insurance cover according to the slab they

fall under.

Expensive treatment

Many HIV-infected people living in India have been unable to obtain

treatment due to the high cost of anti-retro viral treatment, which

costs as much as Rs 10,000-15,000 per month.

" Under this project, people suffering from HIV-AIDS and high risk

group will be insured. After that, normal people will be included in

it so that it is beneficial for the insurance companies too, " says

Dr Ashok K Rau, Director, Freedom Foundation.

Unofficial figures suggest that in Karnataka alone, over six lakh

patients are suffering from AIDS.

Most of these belong to the labour-migrant class and this scheme

aims to reach this particular class so that their fight against the

disease is made slightly easier.

http://www.ndtv.com/template/template.asp?

template=Aids & slug=AIDS+patients+to+get+health+insurance & id=86658 & cal

lid=1 & category=National

[Guest guest]

Dear Forum,

Just saw a posting on AIDS INDIA regarding the proposed Freedom Foundation

Health Insurance project

Some corrections are necessary

Freedom Foundation is looking at the feasibility of an insurance scheme for

people living with HIV/AIDS. To understand the feasibility the foundation is on

the threshold of starting a pilot project for the next two years to understand

and demonstrate the feasibility.

As of now neither National Insurance nor The Government of India is involved

financially or in any other way with the project. The cost of Anti retrovirals

in India (generic) depends on the combinations, but is definitely NOT between

10,000 to 15,000 rupees.

Have requested NDTV to issue a correction ASAP. Appreciate an immediate

correction on AIDS INDIA

______________________

The Freedom Foundation’s Pilot Health Insurance (feasibility) Project (HIP)

EXECUTIVE SUMMARY: The Health Insurance Project (HIP) is a joint venture between

UNDP and FF aimed at exploring the feasibility of offering an insurance cover to

PLHAS that would take care of their medical expenses including cost of anti

retroviral treatment. As of date there is no such scheme which insures let alone

covers an individual with pre existing disease. Due to the nature of this

intervention it is being taken up as a pilot intervention over an initial phase

of 2 years and subject to successful demonstration may be continued by an

insurance company.

Expanded access to anti retroviral drugs in resource poor settings is fast

catching up mainly due to the reduced cost of drugs, enhanced availability of

cheaper generics and increased financing from both government and various other

donors both national and global.

The multi dimensional impact of treatment has been well established especially

by the Brazilian model even in terms of financial sensibility. In short it makes

more sense to enhance access to treatment and reap the benefits from an

individual, family, community and national perspective.

Keeping in mind the above realities it becomes all the more important to explore

various options of self sustainability and one of these is the possibility of an

insurance scheme that would include rather than exclude PLHAS from such

assistance. Despite the fact that access to ART based on availability is no

longer a concern including the reduced prices, affordability still plays a major

role in determining who would have access to treatment.

Even though the cost of drugs has reduced, the burden it puts on individuals and

families who want to continue on treatment is serious enough to cause severe

economic hardships. Though the only individuals who are covered by insurance at

the moment are those who are in central government employment under various

schemes. As of now no product exists that can be marketed by insurance companies

on a general basis. Though amended versions may be possible they would still be

confined to the very few.

Hence this project aims at implementing and demonstrating a workable model that

would provide a solution to the above scenario and pave the way for a major

advance in this direction.

OBJECTIVE: The primary objective is to cover the cost of ARV’s, OI management

and periodic testing including CD4 counts under the health insurance scheme

thereby enhancing access to treatment in Karnataka to start with. Being a pilot

project it becomes necessary to implement it in a controlled and limited region.

BENEFICIARES: The principal beneficiaries will be those PLHAS who are accessing

care at the various Freedom Foundation units in Karnataka, and this will extend

to all who may be referred to the Freedom Foundation units in Karnataka as well.

COVERAGE: An initial target of 158 PLHAS will be recruited in year 1 and

followed up for the second year as well. If the pilot fails then the project has

an inbuilt financial mechanism in the project that would sustain the treatment

of these individuals for a period of the next three years. This revolves around

the ethical considerations of treatment continuation.

OPTIONS: Though 3 options have been designed as follows-

1. All ART eligible individuals visiting Freedom Foundation

2. All HIV positive individuals visiting Freedom Foundation or testing positive

either

3. All vulnerable individuals visiting Freedom Foundation

Only the first option will be explored during the initial phase.

Premiums will be collected on a quarterly basis with FF acting as the insurer

for the pilot phase. All services will be rendered through FF with a team that

will be equipped to handle the treatment as well as the financial records

pertaining to the project.

Conclusion: In conclusion it must be understood that this is a feasibility

project and in no way states that the project would be a success or that it is

commercially viable to become a full-fledged Health Insurance scheme for people

living with HIV/AIDS. In case the project fails due to lack of financial

sustainability, this project has been financially underwritten to cover the

cost of ART drugs and monitoring for the next three years, wherein all 158

clients would be provided the cost of ART drugs only.

All clients would be educated to know of the various risks involved in the

ongoing sustainability of the scheme. The recruitment for this project is purely

voluntary and is based on the willingness of the client to participate with a

complete understanding all the terms and conditions.

The Freedom Foundation’s HIP project only suggests the possibility of

demonstrating a viable Insurance scheme for people living with HIV/AIDS and is

in no way establishing an Insurance scheme for all people living with pre-

morbidity (existing) diseases, be it HIV/AIDS or other diseases.

Regards

Best

Ashok Rau

Executive Trustee/CEO

Freedom Foundation

E-mail: <freedomtrust@...>