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October 31, 2008

Cómo obtener cobertura de seguro médico para una familia

Filed under: health & fitness — admin @ 12:19 am
Lalit Kumar asked:


un seguro de Salud de la Familia te ofrece la cobertura médica y diversos beneficios para el cuidado de la salud en caso de circunstancias imprevistas. La familia y la cobertura de seguro de salud tiene en cuenta la totalidad de gastos de atención médica y de enfermería a largo plazo o de privación de las necesidades de atención. Para garantizar la seguridad de su familia, es imperativo que usted elija el derecho de cobertura de seguro de salud.

Si usted está buscando cobertura de seguro de salud de la familia o grupo de cobertura de seguro de salud, opten por políticas que permitan una salud óptima beneficios para el cuidado de las primas a precios asequibles. La prima la atención de la salud desempeña un papel importante al decidir sobre un seguro de salud. Pero siempre dan importancia a las prestaciones del seguro médico y cobertura.

Las principales compañías de seguros de salud ofrecen hoy y el grupo de seguro de salud familiar con cobertura de seguro de salud asequible primas. Con el aumento de costos de la atención de la salud y una mayor concienciación, la gente está ahora comprando un seguro de salud como nunca antes. Para aprovechar al máximo esta gran alcance, las compañías de seguros son innovadoras concocting diversos planes de seguro de salud, como el flotador concepto de impuestos y planes de ahorro óptimo.

El flotador seguro es ideal para la familia las necesidades de atención sanitaria. Abarca toda la familia en virtud de una póliza de seguro y una prima. Los beneficios / cobertura son compartidos por todos los miembros de la familia.

Con tantos planes en el mercado, es importante que elijas el que mejor se adapte a usted la sabiduría. Compare las tarifas y las primas en las pólizas de seguro que estos se ofrecen. También comparar la cobertura y las prestaciones incluidas. Elija el plan de seguro de salud , que satisfaga todas sus necesidades de atención médica en la mejor prima. También consulte por otras prestaciones, ofertas o descuentos disponibles junto con los planes de seguro de salud. Estos pueden incluir control de la salud gratuita o de pago fácil.

Además de las primas asequibles, la mayoría de las compañías de seguros de salud ofrecen un plan de seguro de salud de la familia sobre una base sin efectivo. Efectivo en virtud de la liquidación de los siniestros, la compañía de seguros paga el instituto de la atención de la salud o al hospital directamente. Así, se obtiene el beneficio de la manipulación y el ahorro de sus finanzas mejor. Las compañías de seguros ofrecen una amplia gama de pólizas de seguro que difieren en su grado de cobertura. La prima varía también en consecuencia.

Una cobertura de seguro de salud de la familia incluye los costos de la atención médica y el tratamiento de las enfermedades y los accidentes que requieren hospitalización. Algunas compañías de seguros ofrecen cobertura de enfermedad grave. Los planes de seguro de salud de la familia también incluye beneficios de la exención de impuestos como se indica en el artículo 80D de la Ley del Impuesto sobre la Renta.



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October 29, 2008

Health sector Reforms in Andhra Pradesh

    A review on Health sector reforms in India   The health sector reforms in India were started way back in 1970s .The Govt. of India identifies the need HSR and stated in the eighth five year plan. The Eighth Five Year Plan (1992-1997) was the first plan document to state the need for re-structuring of economic management systems, following the macro developments of the 1990s. During this period in the health sector, the concept of free medical care was revoked and people were required to pay, even if partially, for the health services (1). The Ninth Five Year Plan (1997-2002) emphasized the need to review the response of the public, voluntary and private sector health care providers as well as the population themselves to the changing health scenario, to reorganize health services to bring about greater efficiency and effectiveness and to introduce health system reforms to enable the population to obtain optimum care at affordable cost The Ninth Plan sought to increase the involvement of voluntary, private organizations and self-help groups in the provision of health care and ensure inter-sectoral coordination in implementation of health programmes and health-related activities as well as enable the Panchayati Raj Institutions (PRI) in planning and monitoring of health programmes at the local level so as to bring about greater responsiveness to health needs of the people and greater accountability; to promote inter-sectoral coordination and utilise local and community resources for health care(2) .The Tenth Five Year Plan (2002-2007) touches upon reforms at primary, secondary and tertiary level(3).                         Politics influence health systems in significant manner. The goals, priorities, and the strategies, variations in the commitment are largely decided through the political contingencies. There are competing demands on the health systems. The evolution of the health systems is largely shaped by the culture, history, and norms. Client satisfaction is very high. As per NFHS-2 data, an overwhelming majority of clients are satisfied by the services delivered by the public systems. May be the expectations are low or may be our people are so courteous. But on the hand, we have the report from Transparent International, ranked the health system in India is the most corrupt system (4)   The Government has taken several steps for improving the public health care institutions and Strengthening the primary health care infrastructure. However, the situation is compounded by severe resource constraints - financial, technical and human power related, which has resulted in policy makers as well as programme managers at differing levels being faced with difficult choices. In such a situation, attempts are being made through various reform initiatives to ensure that the health needs of the people are met One of the major reform initiatives underway is the Secondary Health System Strengthening Project funded by the World Bank in seven states (Andhra Pradesh, Karnataka, Punjab, West Bengal, Maharashtra, Orissa and Uttar Pradesh). The projects include strengthening FRUs/CHCs and district hospitals so as to improve the availability of emergency care services to patients, to reduce overcrowding at district and tertiary care hospitals, construction works, procurement of equipment, increased availability of ambulances, drugs; improvement in quality of services following skill up gradation training in clinical management, changes in attitudes and behavior of health care providers; reduction in mismatches in health personnel / infrastructure; improvement in hospital waste management, disease surveillance and response system. It is essential to assess both progress and problems in implementation of the reforms in each state and to appropriately modify the content and pace of implementation. Such an overview and analysis of all related issues is necessary to provide evidence to policy makers and other stakeholders in terms of the various dimensions and impact of health sector reform.(5) In the Indian Constitution, health is a state responsibility. During Adjustment, many state governments in India had recourse to Health Systems Development Project loans from the World Bank for carrying out health sector reforms (HSR), of which one of the key policies has been to raise public spending on health care from the abysmally low levels seen up to then. The Health Systems Development Project seeks to develop strategic management capacity; strengthen performance, accountability, and efficiency; and build implementation capacity. Further, it seeks to improve clinical service quality by renovating and expanding district, sub district, and community hospitals and improving access to services. In all seven reforming states, around 15% of the total project cost is borne by the state governments. All the project documents note the low levels of funding for secondary hospitals in the reforming states. This is attributed to the small share of overall public spending allotted to health, the limited portion of total health spending going to hospitals, and, within this, a skewed distribution of funds in favour of the tertiary hospitals. After analysis of the problems of the health sector, the governments of the reforming states have agreed-using terminology ranging from “assurances” to “commitments”-to several undertakings. These are: (i) to enhance the overall size of the health budget; (ii) to redress imbalances in public expenditure between secondary and tertiary care levels; (iii) to safeguard the operations and maintenance components of current expenditure allocations for the secondary health-care sector; (iv) to charge user fees for selected services; and (v) to address workforce issues. The Health Systems Development Project initiated in the seven states recognizes the need for enhanced public spending on health and identifies it as the foremost policy reform to be pursued. Nevertheless, such assurances and conditions have not succeeded in enhancing health sector budgets in states implementing HSR. Worse, HSR has not been able to arrest the decline in the share of health spending within total government spending. The Indian system is especially complicated, as the larger tax resources are controlled by the central government but the major responsibility for health-care spending is bestowed on the states (6).Andhra Pradesh is the first state to go with the HSR.               Health sector reforms in Andhra Pradesh   The state of Andhra Pradesh was formed on 1st November, 1956 under the States’ reorganization scheme. It is the fifth largest State with an area of 2, 76, 754 sq. km, accounting for 8.4 % of India’s territory and also the fifth most populous state with a Population of 75 crores. The state has varied physiographic features ranging from high hills, undulating plains to a coastal deltaic environment. Administratively, Andhra Pradesh is divided into 23 districts, 79 revenue divisions, 1123 mandals, about 27000 villages and 264 towns. AP’s economy grew at 7.2% during 2006-07 — the fourth consecutive year of 6% plus growth. The latest poverty headcount ratio stands at 16%, compared to 23% for India . the third-highest credit rating among the major Indian states; the third best investment climate in the country; and the fourth-lowest corruption level among Indian states Andhra Pradesh was the first Indian state to receive a multi-sector Bank operation - the Andhra Pradesh Economic Restructuring Program for US$ 550 million in 1997 - aimed at helping the state accelerate policy and institutional reforms across a wide range of sectors under a common fiscal framework. It is also the only Indian state where the Bank has disbursed three budget support operations - the First Andhra Pradesh Economic Reform Loan (APERL-1) in March 2002, the Second APERL in February 2004, and the Third APERL in January 2007 - that sought to support the state’s development program.(12) Within AP there are regional, social and gender disparities. Health outcomes are worst among Scheduled Castes (16% of population) and Scheduled Tribes (7% of population), especially those living in underserved areas in North tribal and South drought prone districts, and for women. Effective delivery of quality basic health services is hampered by demand and supply side issues, including poor health infrastructure and staffing.(15)     The reform history in health sector in the State can be traced to Andhra Pradesh First Referral Health System Project, one of the first World Bank aided health system projects in the country. This project, launched in 1995 had been implemented by AP Vaidya Vidhana Parishad (APVVP). Agencies like World Bank and DFID are supporting the reform process in the State. The Bank supported the AP Economic Restructuring Project which included improvement of primary health care as one of the component.(7) The priority reforms focus on improved access to quality and responsive health services, strengthened governance and management in health sector, improved institutional mechanisms for community participation and systems for accountability; and strengthened financial management systems.(15)  The government of Andhra Pradesh [GoAP 1999] Vision 2020 document identifies a seven-point set of priorities for health sector reform: providing universal access to primary healthcare; encouraging private investment in tertiary healthcare; focusing on specific programmes to promote family planning; focusing on improving health levels in disadvantaged groups and backward regions; ensuring a strong prevention focus; enhancing the performance of the public health system; and formulating a state information education and communication (IEC) programme to broadcast information on preventive healthcare.(13) The Government of Andhra Pradesh is embarking on a major health sector reforms to improve health care delivery in the State. D.F.I.D. has expressed its willingness to support these initiatives with a grant of 100 Million pounds over the next five years (2006-2011). The reform initiative will include measures to improve the effectiveness and accountability of public health services, measures to focus on community centric preventive healthcare system and enhance access to quality healthcare for the poorer sections of the population(14) DFID will provide up to £40 million health sector budget support to the DoHMFW, GoAP, over 3 years 2007 - 2010. The sector support will build synergy with National Rural Health Mission (NRHM) which is a health sector reform program of the central government for decentralisation, pro-poor focus, strengthening service delivery(15)     The health sector support will be provided over three years (2007-08 - 2009- 10). It aims at increased use of quality health services, especially by the poorest people and in underserved areas.(16) The main outputs will be: a) Improved access to quality and responsive services, especially in remote and interior areas; b) Governance and management of health sector strengthened; c) Institutional mechanisms for community participation and systems for accountability in functioning; and Financial management systems strengthened and improved public expenditure on health.   The performance of health services would be measured against(17)

* greater effectiveness and improved outcomes of existing programs;

* improved efficiency in the allocation of resources;

* greater access and equity; and

* consumer satisfacfion

Reforms underway in health sector   The major reforms underway are classified under these categories and the activities are noted below and we will look each of them in detail    (I) Reorganization and restructuring of existing government health care system

Establishment of Andhra Pradesh Vaidya Vidhana Parishad Strengthening of referral institutions and fixing of service norms Improvement in drug supplies Formation of Andhra Pradesh Health, Medical & Housing Infrastructure Development Corporation (APHM&HIDC) Strengthening of PHCs as 24-hour MCH centers Establishment of Comprehensive Obstetric & Neonatal Care (CEmONC) centres

(II) Changes in health system organisation, delivery and Management

Formation of Hospital Advisory Committee/ Hospital Development Societies for all PHCs and FRUs/ teaching hospitals Provision of free travel bus passes to pregnant women for antenatal check ups Public Private Partnership

(III) Changes in financing methods

Sukhibhava Scheme (Improvement of Institutional Delivery Services Scheme) User fees

(IV) Reforms related to human resources

Integration and responsibilities of functionaries for planning, implementation and monitoring of programmes of HM & FW department

(V) Involving community in health service delivery and Provision

Women Health Volunteers Scheme

(VI) Reforms to quality of care

Performance indicators for grading the PHCs Performance rating of secondary hospitals

    1.Reorganization and restructuring of existing government health care system   A)Andhra Pradesh Vaidya Vidhana Parishad   AP, has created the Andhra Pradesh Vaidya Vidhana Parishad (APVVP) by enacting an Act in the Legislative Assembly in 1986(8) This was done with the objective to lay greater emphasis on development of both preventive as well as curative health care  and to strengthen necessary linkages at appropriate levels to ensure comprehensive medical and health care services. APVVP has undertaken World Bank assisted Andhra Pradesh First Referral Health Systems Project (APFRHSP) in 1994 for a period of seven years. This has been one of the major projects undertaken by APVVP. The objectives of the project included improvement of efficiency in the allocation and use of health resources through policy and institutional developments and enhanced performance of health system by improving the quality, effectiveness and coverage of health services at the first referral level.   B)Strengthening of referral institutions and fixing of service norms   basic service norms for various categories of hospitals under the administrative control of APVVP have been fixed thereby creating a hierarchy of hospitals according to services and facilities. This system of service norms and referral linkages had been developed with a view to optimise utilisation of resources, avoid duplication and wastage of resources, regulate patient flow and reduce cost of treatment by reduction of patient burden at tertiary hospitals. the district hospital has been prescribed to provide services in eleven specialties for which 9 civil surgeon specialists, 18-20 civil assistant surgeons, 54-84 paramedical staff and other supporting staff have been Posted. C)Improvement in drug supplies To ensure regular supply of drugs at all times and in all situations, a system of three sources of drug supply has been put in place for the hospitals under APVVP: (a) centralised drug procurement system under which the institution has been allotted drugs worth a particular amount based on bed strength (Rs 2000 per bed per quarter); (b) an emergency provision for drugs (Rs 100 per bed per month) has been made to every institution from where emergency procurement of drugs is made; (c) drugs which are in short supply and for which regular rate contract suppliers are not available have been stocked at the office of District Coordinators of Health Service. Under the APFRHSP, const-ruction and repair of 160 hospitals including 81 CHCs, 58 area hospitals and 21 district hospitals had been undertaken.(10)         D)Formation of Andhra Pradesh Health, Medical & Housing Infrastructure Development Corporation (APHM&HIDC)   a separate corporation has been set up in 1987 exclusively for developing housing and other infrastructure for medical and paramedical staff and constructing sub centers, PHCs, hospitals, dispensaries, clinics and other health care centers One of the major projects undertaken by APHM&HIDC has been the World Bank assisted India Population Project-VIII launched for improving the medical care facilities in urban slums in 74 municipalities.   E)Strengthening of PHCs as 24-hour MCH centers   In a move to make available maternal and child health care at all times, 470 PHCs in backward districts have been designated as round the clock Mother and Child Health Centre (earlier called women health centres). One staff nurse, one ANM and three support staff have been appointed in each centre on contractual basis. Staff nurses have been trained to conduct normal deliveries and refer emergency cases. Additional facilities like telephone and vehicle have been provided to the PHCs in order to assist communication and transport for referral of emergency cases. Provision has been made to conduct fortnightly specialist clinics of gynaecology and paediatrics in these centres to detect high risk pregnancies and neonates for referral to FRUs.   F)Establishment of Comprehensive Obstetric & Neonatal Care (CEmONC) centres   The State Government has decided to establish 108, CEmONC centres spread across every district so that pregnant mothers requiring emergency care do not have to travel more than 40-50 kms to receive specialist care. Training of MBBS doctors in anaesthesia, neonatal care and blood transfusion is also planned to support this scheme.   2)Changes in health system organisation, delivery and Management A)Formation of Hospital Advisory Committee/ Hospital Development Societies for all PHCs and FRUs/ teaching hospitals   Hospital Development Societies have been constituted in all tertiary hospitals under the control of Directorate of Medical Education.(18) and after implementing NRHM rogi kalyam samithi at every PHC were formed to ensure the adequate participation of local institution,with an aim to improve effective and efficient services with allowed flexible financial powers. These societies are examples for decentralization . Activities of the society include maintenance of the hospital (including sanitation & water supply, electricity, building & civil works and equipment), purchase of drugs & medicine supplies and equipment. The government has set norms and limits for undertaking these works which are to be adhered to by the Society. The ‘system works’, observed an Unicef team which assessed the impact of RKS towards the end of 2000. The system, however, is not without any lacunae. For, it was pointed out that “overall control of the local RKS bodies remain in the hands of the collector and if he is not interested in health care then the whole thing might just drift(13)   B)Provision of free travel bus passes to pregnant women for antenatal check ups(19)   The Government of Andhra Pradesh has started an innovative scheme in order to enable pregnant women in rural areas to avail antenatal check ups at the nearest PHC/area hospital or FRU. It has tied up with the State Road and Transport Corporation to issue free transportation bus tickets pass to be utilised for three visits. The ANM issues the bus passes to the pregnant women on her house visits.       C)Public Private Partnership(20)   ·         Management of Urban Health Centers by NGOs   Under the World Bank assisted Andhra Pradesh Urban Slum Health Care Project (APUSHCP), 192 urban health centers (UHCs) have been established in 74 municipal towns in 21 districts covering 1848 slums. After withdrawal of support by the World Bank, the project has been funded by the state government since 2002. The outcomes of the project show marked improvement in ANC coverage, institutional deliveries, post natal care and immunisation in the slum population.   ·         108 emergency services                           Govt. has tied up with satyam computers to provide emergency transportation which proved to a most successful programme and many states are following the same like Gujarath. The objective of 108 Ambulances is to save people in life emergency . One ambulance is given for three mandals. Each ambulance fitted with equipment worth Rs.17 lakhs renders its services in life emergencies, road and fire accidents (22)   ·         Rajiv arogya sree    The innovative Govt. insurance scheme to serve people of  poor from the serious ailments now attracting the nation as this programme succeeded. this scheme provides financial support to families of BPL upto 2 lakhs per anum for treating serious ailments. it is proposed to cover the entire state by 2nd October 2008 with the govt. paying the insurance premium for all the beneficiaries .an amount of rs.450 crores are provided to implement the scheme during 2008-09. (21)       3)Changes in financing methods   A)Sukhibhava Scheme(23)   Under the Scheme, a cash assistance of Rs.300 (Rs 200 towards transportation charges and Rs 100 for food and incidental expenses) is paid to pregnant women belonging to below poverty line families who come to government hospitals/APVVP hospitals/ teaching hospitals/PHCs/CHCs for delivery serv-ices. This assistance is payable only to those women with no living children or with one living child.   B)User fees:-   If user fees are charged their main use may lie in optimization of expenditure patterns and better allocation between facilities and within facilities(24). Reddy and Vandemoortele (1996), based on a comprehensive review of user financing of basic social services carried out for UNICEF, point to three other discouraging features of user fees: (1) user financing can result in a sharp reduction in the utilization of services, particularly among the poor; (2) gender biases, seasonal variations and regional economic disparities can aggravate the effects of user financing on equity; (3) user financing  quires adequate capacities, effective decentralisation and continued government support; and (4) user financing can undermine political support for the goal of universal coverage of basic social services. In 2001, the Commission on Macroeconomics and Health (2001) also reached a similar conclusion that user fees end up excluding the poor from essential healthservices, in 2005, the Millennium Project’s recent Report to the UN Secretary General (2005) titled “Investing in Development - A Practical Plan to Achieve the Millennium Development Goals” also forcefully argues for abandoning user fees. The health sector in India has acquired a notorious reputation for inefficiency and corruption at all levels. There is little accountability in both the public and private sectors. Quality standards are practically non-existent as are performance measures and honest reporting. A recent report on human resources for health brought out by Harvard University’s Global Equity Initiative (2004) argues that it is people - health workers alone - who can produce an effective health system and deliver good ealth.(25) 4)Reforms related to human resources Integration and responsibilities of functionaries for planning, implementation and monitoring of programmes of HM & FW department At district level, District Health Coordination Committee (DHCC) has been constituted to ensure proper planning, implementation and monitoring of all programmes/activities of HM&FW Department in the district.  The Committee has been entrusted with the primary responsibility of planning, finalizing, implementing and monitoring the District Health Action Plans and institutionwise health plans in a participatory manner including all concerned officials, other concerned departments and NGOs.   5)Involving community in health service delivery and Provision  

Women Health Volunteers Scheme

  One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist - ‘ASHA’ or Accredited Social Health Activist. Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system. Following are the key components of ASHA(26) A woman, usually a daughter-in-law of a house who has studied upto 7th class and preferably from SC/ST community has been selected as WHV by the Gram Panchayat Health Committee. The selected WHV has been given one month training in health care aspects of pregnancy, antenatal, delivery, post natal and new born care, immunisation, diarrhoea, acute respiratory infections, first-aid and treatment of minor ailments. The training has been provided at Telugu Mahila Pranganams for three weeks and one week field level training at PHCs. Academy of Nursing Studies has been designated as the nodal agency for providing training to WHVs.   6)Reforms to quality of care   A)Performance indicators for grading the PHCs   One of the components of World Bank assisted AP Economic Restructuring Project is improvement of primary health care. In order to improve the quality of primary health care services, a system of performance rating has been developed to rate PHCs and CHCs. The grading has been accorded A to C in descending order   B)Performance rating of secondary hospitals   A performance rating system for secondary hospitals under APVVP has been  introduced. The indicators related to general services (outpatients, inpatients, bed occupancy), emergency services (emergency-OP, emergency-IP, emergency major operations, emergency minor operations), clinical services (major/minor operations, tubectomy, deliveries) and diagnostic services (X-ray, ECG, lab tests and USG) have been developed for the purpose. Normative targets for each type of hospital (district hospital, area hospital, community health center) have been fixed against which the performance is measured and rating assigned. Highest grading is A while lowest grading is C.(27)   Conclusion:-   Introduction of user charges and subcontracting of services to the private sector are the main elements of health sector reforms. The health sector reforms are only a part of drastic reforms in other major sectors undertaken as a part of Andhra Pradesh Economic Restructuring Project (APERP) and the overall impact on the health conditions of people and their access to medical care depend more on the changes proposed outside the health sector. For instance, while exempting the white ration card holders i.e. the poor from the user charges in the government hospitals, it proposes to drastically reduce the number of white card holders to half in the state. The net affect would be to reduce the percent of population eligible for free treatment.(29)   On the other hand the success of 108 EMRI services and overwhelming response from Rajiv Arogya sree scheme are the examples for HSR success. Just like every thing has gots its own pros and cons HSR should be done in such a way where the need exist and according to necessities .   Referances:-   (Note:-most part of the article was taken from ref.no 28 otherwise reference specified)

 

(Government of India, Eighth Five Year Plan, (1992-1997) Planning Commission, New Delhi.) (Government of India, Ninth Five Year Plan, (1997- 2002) Planning Commission, New Delhi ) ( Government of India, Tenth Five Year Plan (2002-2007) Planning Commission, New Delhi) ( D. Agarwal Health Sector Reforms: Relevance in India, Indian Journal of Community Medicine Vol. 31, No. 4, October-December, 2006) Health Sector Reforms in India, Initiatives from Nine States ( http://www.idrc.ca/en/ev-118491-201-1-DO_TOPIC.html.The international development research centre) http://www.worldbank.org.in  (The Andhra Pradesh Vaidya Vidhana Parishad Act 1986 (Act No. 29 of 1986 with Amendaments upto 31.03.1989  Dr. MCR Human Resource Development Institute of Andhra Pradesh (Undated). “Andhra Pradesh Vaidya Vidhana Parishad Departmental Manual”  6http://www.aponline.gov.in/apportal/departments/ departments.asp?dep=16&org=98 GoAP (2006), Response to Questionnaire on Health Sector Reforms from MOHFW, GoI. http://www.worldbank.org.in/WBSITE/EXTERNAL/COUNTRIES/SOUTHASIAEXT/INDIAEXTN/0,,contentMDK:20970681~pagePK:141137~piPK:141127~theSitePK:295584,00.html#Ongoing_projects Grish kumar,promoting PPP in health services,EPW commentary,july19,2002  (G.O.Ms.No.130, HEALTH MEDICAL AND FAMILY WELFARE (K2) DEPARTMENT. Dated the 24th April, 2006)  ANDHRA PRADESH HEALTH SECTOR REFORM PROGRAMME (APHSRP) Terms of reference for Technical Cooperation (TC) to DoHMFW, GoAP  PRESS INFORMATION BUREAU GOVERNMENT OF INDIA, HEALTHCARE PROJECT IN AP FUNDED BY DFID, New Delhi, March 5, 2008) http://lnweb90.worldbank.org/oed/oeddoclib.nsf/DocUNIDViewForJavaSearch/0CFD6217A8A5BDA2852567F5005D32BD  G.O.Ms.No.403, dated Sept 7th 1998  GoAP (2006), Response to Questionnaire on Health Sector Reforms from MOHFW, GoI. Power Point Presentation of Govt of AP at the 2nd Regional Workshop on Health Sector Reforms: Experiences of Select States at Hyderabad, 14-15th February 2005 and ECTA Working paper 2002/61 Public-Private Partnership: Operational Framework used in Andhra Pradesh and Assam http://www.scribd.com/doc/2208678/AP-Budget-Speech  http://pibhyd.ap.nic.in/er27070702.pdf  Dept. of Health Medical Family Welfare, GoAP (undated), “Sukhibhava (Improvement of Institutional Delivery Services Scheme): Implementation Guidelines to PHC/Hospital  http://mohfw.nic.in/NRHM/Documents/CRM_report_full_report_version.pdf   (A.K.Shiv Kumar,,Budgeting for health ,some considerations) Economic and Political Weekly April 2, 2005  http://mohfw.nic.in/NRHM/asha.htm#abt http://health.ap.nic.in/apvvp/apvvp_stat.html  (http://www.whoindia.org/linkfiles/health_sector_reform_hsr_vol_ii_-_andhra_pradesh.pdf)  (Impact Of Health Sector Reforms On Hospital Services In Andhra Pradesh - A Study Of Trends In The Structures Of Provision And Utilisation Pattern)(centre for economic and social studies) (http://www.cess.ac.in/cesshome/research6b.html)

       

 

Filed under: health & fitness — admin @ 3:21 am
Dr.v.sudhakaram asked:




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October 18, 2008

Uninsurable for Health Insurance?

Filed under: health & fitness — admin @ 1:43 pm
Individuals with pre existing conditions like diabetes, cancer, heart disease, heart attack, stroke, kidney disease, liver disease, AIDS, depression and a long list of other health conditions, have found it almost impossible to find affordable healthcare. These health issues are causing thousands of individuals to be declined for health insurance. If you are looking for uninsurable health insurance or pre existing condition health insurance, you know how hard a task that can be.

Sometimes preexisting conditions allow an insurance company to deny your health insurance request. However, there are ways you can be provided with affordable healthcare coverage. If you can combine creative insurance planning with the knowledge and understanding of what is available, you’ll greatly reduce the chance of potential financial strain on you and your family.

Should you find an insurance company that will provide health insurance; you’ll quickly discover that this coverage is not cheap. And… the coverage will probably be limited in scope when compared to the coverage for someone with no known health problems. The bottom line is this, whatever coverage you can get, it’s probably best to take it until something better comes along.

You can find affordable health care. I have listed 6 choices below.

Group Health Insurance: The best choice for those with a chronic conditions, pre existing conditions or even uninsurable. It’s really a guaranteed issue health insurance plan. With group health insurance, coverage is usually provided by your employer or your spouse’s employer. The employee will typically have little, if any, choice concerning the features of the coverage. The main advantage of group insurance: new employees will usually get coverage without any medical questions or concern for a pre existing condition. One disadvantage: coverage usually ends when the employee’s job ends.

Professional Organizations: Most don’t know about this option. A number of professional organizations offer their members a health insurance program as a fringe benefit. This health insurance coverage could be a great way to stay insured if you are uninsurable or have a preexisting condition. This is really like a group health insurance policy. See if you can get access to a membership organization which offers health insurance for preexisting conditions or health insurance for the uninsurable. A valid certification or career experience may be required to join. Other associations might accept your membership without these prerequisites. Look for local and national associations. Even with a yearly membership fee, it still might be worth the money.

Private Individual Health Insurance: If you are without group healthcare coverage from an employer or professional organization health plan, yet you have pre existing conditions that have caused you to be uninsurable, obtaining individual health insurance is probably going be a little tough. If you do find coverage, the premiums will often times be unaffordable. However, this still might be your best choice for now. You can always go with a better plan in the future.

State Risk Pools: For individuals who have serious medical conditions, some states allow access to either private individual health insurance for uninsurable or health plans for uninsurable. These plans are defined as high-risk health insurance pools. Individuals in these state risk pools have access to comprehensive private coverage plans. However, the premiums can be very costly, often double what private health insurance would cost for someone who is healthy. Individuals may find enrollment is closed to a new enrollee or the state pool has a long waiting list. These high-risk pools are often the last resort for people who have serious pre existing conditions and are paying exorbitant fees for their insurance, or who are able to meet key state conditions for enrollment.

Discount Health Cards: Companies selling discount health cards claim to save subscribers money by offering discounts on a hospital, doctor, prescription drugs, dental, vision and chiropractic care. Consumers seeking affordable healthcare may be confused by these health cards. They really are not health insurance. You’re still responsible for paying the medical bills. The discount health card simply offers a reduced price for services from participating healthcare providers. They often times make grossly inflated promises on expected benefits and savings. Use caution when purchasing these discount health cards. You may pay more than you save.

Guaranteed Issue Health Insurance: For those who are uninsurable, those with preexisting conditions or someone who just can not afford or qualify for health insurance, then a guaranteed issue health insurance plan may be a good choice. These plans, known as “mini-meds”, are not to be confused with “discount health cards”. These plans are usually quite affordable and offer a considerable amount of coverage. Most pre existing conditions are covered after 12 months. Understand these plans are not basic health insurance or major medical coverage but are limited indemnity plans. This just means the plan pays benefits based on a pre-defined amount per service or procedure. Usually covered are doctor visits, hospital stays, emergency room visits, surgery, accidental death, etc. Most do not require completing medical questions or taking a physical exam to qualify.



By: Rudy Wilson

About the Author:

Rudy Wilson is currently active in the insurance industry. He is also a researcher and an author. Visit his web site at http://www.UninsurableHealthSolution.com to view more information on finding affordable health care for the uninsured, the underinsured and the uninsurable.



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PrimärGesundheitszentrum (Ausgaben, Stärke und Bereich)

Filed under: health & fitness — admin @ 9:10 am
Tafsirul Mazahir asked:


Die Primärstrategie der gesundheitspflege (PHC) ist ein Drehpunkt in der Geschichte von Gesundheitspflegepolitik gewesen. PHC wurde als ⠀ œ wesentliche Gesundheitspflege definiert, die auf den praktischen, wissenschaftlich stichhaltigen und gesellschaftlich annehmbaren Methoden und der Technologie basierte, gebildet allgemeinhin zugänglich zu den Einzelpersonen und zu den Familien in der Gemeinschaft durch ihre volle Teilnahme und an Kosten, die die Gemeinschaft und das Land sich leisten können, um in jedem Stadium der Entwicklung im Geist von Selbstvertrauen und Selbstdetermination⠀  beizubehalten. PHC wurde erwartet, um einen wesentlichen Bestandteil des country⠀ ™ s Gesundheitssystems, von dem es die zentrale Funktion und der Hauptfokus ist, und der Gesamtsozial- und ökonomischen Entwicklung der Gemeinschaft zu bilden. Es würde das erste Niveau des Kontaktes der Einzelpersonen, der Familie und der Gemeinschaft mit dem nationalen Gesundheitssystem sein und so nah holen würde Gesundheitspflege, wie möglich zu, wo Leute arbeiten und leben, und das erste Element eines fortfahrenden Gesundheitspflegeprozesses festsetzt.   PHC enthält acht Elemente:  à ¼       Ausbildung hinsichtlich der maßgeblichen Gesundheitsprobleme und der Methoden des Verhinderns und der Kontrolle sie, à ¼       Förderung der Nahrungszufuhr und der korrekten Nahrung, à ¼       ausreichendes Versorgungsmaterial sicheres Wasser und grundlegende Hygiene, à ¼       mütterliche und Kindgesundheitspflege, einschließlich Familienplanung, à ¼       Immunisierung gegen HauptInfektionskrankheiten, à ¼       Verhinderung und Steuerung der am Ort endemischen Krankheiten, à ¼       passende Behandlung der allgemeinen Krankheiten und der Verletzungen, andà ¼       Bestimmung der wesentlichen Drogen.  die Ideologie und Grundregeln hinter PHC bringen nah zusammen, was und ist seit dem befürwortet worden in der menschlichen Entwicklung wie sozialer Gerechtigkeit, Billigkeit, Menschenrechte, Universalzugang zu den Dienstleistungen war und Priorität zum verletzbarsten und unterprivilegiert gab und Gemeinschaftsmiteinbeziehung. Es ist eine anerkannte Tatsache, dass die Förderung und der Schutz der Gesundheit der Leute zu nachhaltigem ökonomischem wesentlich ist und soziale Entwicklung und trägt zur besseren Lebensqualität und zum Weltfrieden bei. Diese Priorität gegebenen PHC als die Hauptstrategie für das Erzielen der Gesundheit für alle. Trotz dieser Verpflichtung und einiger Jahre der Arbeit, ist nicht viel erzielt worden.  dort ist eine Notwendigkeit, die Implementierung der Primärgesundheitspflege zu überprüfen und die strategischen Interventionen zu identifizierenen, die benötigt werden, um mit den neuen Herausforderungen fertig zu werden, die Gesundheitssysteme, als Beitrag zum Entwickeln einer Tagesordnung für die Verstärkung von PHC im 21. Jahrhundert gegenüberstellen.          Schlüsselfragen, die REVIEWED/addressed für die Verstärkung von PHC⠀ ™ s SEIN müssen können, sind:   à ¼       PHC Politikformulierung: Wie wurde die PHC Politik formuliert? Was der Prozess der Formulierung von PHC Politik war, der Inhalt der PHC Politik usw.  à ¼       PHC Politikimplementierung: Wie werden die PHC Maßnahmen durchgeführt? Zu überprüfen die Aspekte umfassen Befürwortung und Marketing, Schauspieler und Partner, Strukturen und verarbeiten etc.  à ¼       PHC Betriebsmittel: Welche Betriebsmittel sind für PHC Implementierung, z.B. Mensch und Finanzquellen, sowie PHC körperliche Betriebsmittel und Strukturen vorhanden?  à ¼       PHC Überwachung und Bericht: Wie werden PHC Politik und Strategien überwacht und wiederholt?  à ¼       Gesundheitstendenzen: Was sind die Tendenzen der Hauptgesundheit und der gesundheitsbezogenen Herausforderungen?      PROCESS Daten, damit der Bericht von den folgenden Quellen erreicht werden kann:  à ¼       Unstrukturierte Interviews mit Interviewten/Berichterstattern, die vertrautes Wissen der PHC Implementierung, wie Politikhersteller, Implementers auf allen Niveaus haben, andere Sektoren bezogen, WHO und andere Partner mit ein.  à ¼       Diskussionen mit einem breiteren Publikum der Leute, die vertrautes Wissen der PHC Implementierung haben. Diese enthaltenen Politikhersteller Implementers, nichtstaatlichen Organisationen, Privatsektor, gesundheitsbezogenen Anstalten, WHO und anderes partners à ¼       Eine Schreibtischanalyse der vorhandenen Dokumente und der Reports spezifisch zum Land und umfangreiche Analyse der ganz vorhandenen erschienenen und unveröffentlichten Dokumente und der Materialien.         ein Bericht des landwirtschaftlichen Gesundheitssystems in Indien:    ist landwirtschaftliches Gesundheitssystem ⠀ “ die Struktur und das gegenwärtige scenario die Gesundheitspflegeinfrastruktur in den ländlichen Gebieten als System mit drei Reihen entwickelt worden (sehen Sie Diagramm 1) und basiert auf den folgenden Bevölkerungsnormen:   1.                  CentrePopulation Norms2.                  Normales AreaHilly/Stammes-/schwierige Gesundheit Centre1,20,00080,000   der AreaSub-Centre50003000Primary Gesundheits-Centre30,00020,000Community Vor-Mitten (SCs)  die Vor-Mitte ist der peripher und ersteste Kontaktpunkt zwischen dem PrimärGesundheitssystem und der Gemeinschaft.   Jede Vor-Mitte wird von einer zusätzlichen Krankenschwester-Hebamme (ANM) und von einem männlichen Gesundheitsfürsorger MPW (M) bemannt (für Details der Stellenbesetzung des Musters, sehen Sie Kasten 1).  Eine Dame Gesundheitsfürsorger (LHV) wird mit der Aufgabe der Überwachung von sechs Vor-Mitten betraut. Vor-Mitten werden Aufgaben in Bezug auf Zwischenpersonalkommunikation, zwecks ungefähr Verhaltensänderung zu holen und Dienstleistungen in Beziehung zu mütterlichem und Kindergesundheiten, Familienwohlfahrt, Nahrung, Immunisierung, Diarrhöesteuerung und Steuerung der Programme der ansteckenden Krankheiten zu erbringen zugewiesen.   Die Vor-Mitten werden mit grundlegenden Drogen für die kleinen Unpässlichkeiten versehen, die für das Kümmern von um wesentlichen Gesundheitsnotwendigkeiten der Männer, der Frauen und der Kinder benötigt werden. Die Abteilung der Familien-Wohlfahrt gewährt 100% Zentraleunterstützung allen Vor-Mitten im Land seit April 2002 in Form von Gehalt von ANMs und von LHVs, Miete mit der Rate von Rs. 3000/- pro Jahr und Möglichkeit mit der Rate von Rs. 3200/- pro Jahr, zusätzlich zusätzlich den Drogen und zu den Ausrüstungsinstallationssätzen. Das Gehalt der männlichen Arbeitskraft wird durch den Zustand Governments. getragen  Unter dem Tauschen-Entwurf hat die Regierung von Indien zusätzliche 39554 Vormitten von den Landesregierungen/von den Anschluss-Gegenden seit April 2002 anstatt Nr. 5434 der landwirtschaftlichen Familien-Wohlfahrts-Mitten übernommen, die auf die Landesregierungen/die Anschluss-Gegenden gebracht werden. Es gibt 146026 Vormitten, die im Land als im September 2005 verglichen mit 142655 im September 2004 arbeiten.      ist Primärgesundheits-Mitten (PHCs)  PHC der erste Kontaktpunkt zwischen Dorfgemeinschaft und dem Arzt. Das PHCs wurden beabsichtigt, um eine integrierte heilende und vorbeugende Gesundheitspflege zur Landbevölkerung mit Betonung auf den vorbeugenden und fördernden Aspekten der Gesundheitspflege zur Verfügung zu stellen. Das PHCs werden hergestellt und beibehalten durch die Landesregierungen unter dem minimalen benötigt Programm (MNP)/grundlegendes minimales Service-Programm (BMS). Zurzeit wird ein PHC von einem Arzt bemannt, der von 14 paramedizinisch und von anderem Personal gestützt wird.   Es tritt als eine Empfehlungsmaßeinheit für 6 VorCentres. auf  Es hat 4 - 6 Betten für Patienten.   Die Tätigkeiten von PHC beziehen heilende, vorbeugende, Primitiver und Familien-Wohlfahrt Services. mit ein  Es gibt 23236 PHCs, das arbeitet als im September 2005 im Land verglichen mit 23109 im September 2004.     Gemeinschaftsgesundheits-Mitten (CHCs)      CHCs werden von der Landesregierung im Rahmen des MNP/BMS Programms hergestellt und aufrechterhalten. Es wird von vier medizinischen Fachleuten der d.h. Chirurg, Arzt, Gynäkologe und Kinderarzt bemannt, die von 21 paramedizinisch und von anderem Personal gestützt wird.   Es hat 30 Innenbetten mit einem OT, Röntgenstrahl, Arbeitsraum- und Laboranlagen.   Es dient als Empfehlungsmitte für 4 PHCs und stellt auch Anlagen für obstetric Sorgfalt- und Fachmannberatungen zur Verfügung. Als im September 2005, gibt es 3346 CHCs, das im Land arbeitet.   ************************************************************************   

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October 1, 2008

Krankenversicherung: Verwirklichen Sie den Wert des Wohls

Filed under: health & fitness — admin @ 8:50 pm
Jenny Black asked:


Das Leben ist von unerwarteten Situationen voll, die unser Bestehen beeinflussen können. Gesundheit ist eine von ihnen. ' Gesundheit ist wealth' ist ein Sprichwort, das seine Bedeutung in den modernen Zeiten verloren hat. Das temporeiche Leben der zeitgenössischen Welt, in der jeder Treffenstichtage und -arbeit in jam-packed festgelegt versucht, wird Gesundheit häufig ignoriert. Es ist, nur wenn, wir unter einer plötzlichen schwierigen Gesundheitssituation leiden, dass wir den Wert unseres Wohls verwirklichen. Gesundheitsinteressen wie Krebs, Anschlag können Sie ohne mehr eine vorherige Anzeige in Verlegenheit bringen. Was tun Sie dann? Wenn Sie eine Krankenversicherung haben, brauchen Sie nicht dich zu sorgen. Eine Krankenversicherung kann Sie unterstützen, um sich um diesem kostbaren Besitz sogar zuzeiten der Bedrängnisses zu kümmern. Krankenversicherung unterscheidet sich erheblich, aber im Wesentlichen bezeichnet sie eine Art Versicherungsplan, der einen vorarrangierten Prozentsatz einer Versicherung possessor' zahlt; s-beiliegende ärztliche behandlungen. Die Frage, ob Sie Gesundheit nicht w5ahlen sollten oder sollten, hängt völlig nach Ihnen ab. Jedoch, ist es immer ratsam, die Versicherung für Gesundheit zu erhalten und hält im Verstand die Ungewissheiten, die moderne Lebensart umgeben. Krankenversicherung kann in den verschiedenen Formen wie Zahnversicherung, Anblickversicherung, KursteilnehmerKrankenversicherung, GeschäftsKrankenversicherung, internationale Krankenversicherung unter anderem erreicht werden. Diese verschiedenen Formen der Krankenversicherung bemühen sich, Ihrer spezifischen Anforderung zu bieten. Krankenversicherung umfaßt normalerweise Krankheitskosten wie: & #61656; Hospitalization& #61656; Behandelt visit& #61656; Verordnung drugs& #61656; Jährliches Überprüfung ups& #61656; Unfallstation visitsYou muss über die verschiedenen Krankenversicherungfirmen viel gehört haben, die Versicherungsprodukte mit lukrativen Umbauten anbieten. Aber es ist bis zu Ihnen geht welches, damit. Wenn Sie an das Verschaffen einer Krankenversicherung denken, kann Internet Sie mit einem einfachen Weg versehen. Über verwirrt was ein bisschen die Krankenversicherung, zum zu gehen für? Eine einfache Weise, nach der gewünschten Versicherung zu schlagen ist, die Erwartung heraus zu weissen, die Sie von ihm haben können, wie gut es zu Ihrer Situation unter anderen Faktoren entspricht. Eine Zusammenstellung der on-line-Krankenversicherungfirmen kann Ihnen eine Wahrscheinlichkeit geben, Krankenversicherung zu vergleichen und auszuwerten, die Ihre Tasche passt. On-line-Anwendungsverfahren für Krankenversicherung kann Ihren Weg beschleunigen, um den meisten bedeutenden Teil Ihres Bestehens sicherzustellen, das Ihre Gesundheit ist. Bevor Sie nach einer Krankenversicherung sich einschiffen, ist es ratsam, mit den Bedingungen der Krankenversicherungversorger vollständig zu sein. Diese Annäherung würde Sie nicht nur am Schritt mit Verfahren der Beschaffung halten und des Arbeitens der Versicherung aber Sie auch von jedem zukünftigen Durcheinander speichern. Verwirklichen Sie den Wert Ihres und Ihres geliebten ones' s-Wohl mit Krankenversicherung. Versicherung für Ihre Gesundheit kann Ihnen ein gesichertes Erwerbsmittel unter dem starken Wald der Gesundheitsausgaben holen.

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