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3846 items in total found

Working Papers | 2001

Analysis of Claims and Reimbursements made under Mediclaim Policy of the General Insurance Corporation of India

Reuben Elan and Bhat Ramesh

Mediclaim insurance run by government owned insurance company General Insurance Corporation of India (GIC) is the only private voluntary health insurance scheme available in India currently. This scheme has been in operation since 1986 and from time to time a number of revisions have been carried out to address the needs of their clients. The documentation on claims and reimbursement of this scheme is scanty. This paper analyses 621 claims and reimbursements data pertaining to policy initiation years 1997-98 and 1998-99 of Ahmedabad branch of one of the subsidiary companies of the General Insurance Corporation of India. The analysis suggests that the number of policies and premiums collected have grown at significant rates, more than 30 per cent during 1998-99 and 50 per cent during the year 1999-00. The growth had implications for the management of scheme in terms of problems of adverse selection or provider induced demand and falling premiums per insured person. It was found that the number of claims increased by about 93 per cent during the year 1998-99 when polices sold grew at 32 per cent. The study estimates that about 1/3rd of claim amount increase is because of the problems of adverse selection or provider induced demand. The analysis of break-up of reimbursements suggests that about 40 per cent of reimbursements are made towards doctors fees. This is followed by diagnostic charges, which accounts for about 30 per cent. This makes the insurance claims highly vulnerable to provider-induced use of resources. The findings also suggest that the insurance company took on an average 121 days to settle the claim. It is pointed out given the demand side and supply side imperfections in the healthcare markets and absence of appropriate regulatory mechanisms in place, the Insurance and Development Regulatory Authoritys proposal to ensure payment settlement within 7 days is highly ambitious. The study also analyses reasons for the delay and cases where reimbursements have been less than claims submitted.

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Working Papers | 2001

Structural Qualitative Method of Forecasting

Naik Gopal

Working Papers | 2001

Experiences of Various Forms of Commercial Partnerships in Indian Railways

G. Raghuram

This paper brings out issues of governance between the Ministry of Railways and various service delivering commercial entities under the Ministry. Some of this is accentuated by both the ministerial and administrative powers vested in the same body, namely the Railway Board. We examine a set of eight case situations, wherein there has been an attempt to focus on a commercial approach. However, the extent of success/failure is varied. A study of these cases brings out the potential of improving railway infrastructure under a governance framework of (i) distancing the ministerial role from the commercial activity, (ii) increased private participation, (iii) improving transparency, contestability and competition, and (iv) appropriate regulations We describe salient features of each of the cases, with comments from the perspective of commercial viability. A concluding section brings out some of the key concepts which would be relevant for such commercial partnerships in the future. At a broader level, given the budgetary constraints, under exploited potential of the IRs assets and service possibilities, lack of commercially oriented professional and accountable management, such commercial partnerships have implicitly been accepted (by both the central government and the top management of IR) as the way forward.

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Working Papers | 2001

Hospital Efficiency: An Empirical Analysis of District and Grant-in-Aid Hospitals in Gujarat

Reuben Elan, Verma Bharat Bhushan, and Bhat Ramesh

This study focuses on analysing the hospital efficiency of district level government hospitals and grant-in-aid hospitals in Gujarat. The study makes an attempt to provide an overview of the general status of the health care services provided by hospitals in the state of Gujarat in terms of their technical and allocative efficiency. One of the two thrusts behind addressing the issue of efficiency was to take stock of the state of healthcare services (in terms of efficiency) provided by grant-in-aid hospitals and district hospitals in Gujarat. The motivation behind addressing the efficiency issue is to provide empirical analysis of governments policy to provide grants to not-for-profit making institutions which in turn provide hospital care in the state. The study addresses the issue whether grant-in-aid hospitals are relatively more efficient than public hospitals. This comparison between grant-in-aid hospitals and district hospitals in terms of their efficiency has been of interest to many researchers in countries other than India, and no consensus has been reached so far as to which category is more efficient. The relative efficiency of government and not-for-profit sector has been reviewed in this paper. It is expected that the findings of the study would be useful to evaluate this policy and help policy makers to develop benchmarks in providing the grants to such institutions.

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Working Papers | 2001

The Proof is in Improved Reading Same Language Subtitling on Television in India

Jadwani Hemlata, Joshi Ashok, Chudgar Amita, Pandey Avinash, and Brij Kothari

Working Papers | 2001

A Simple Tool for Benchmarking Early Literacy Siklls in Indian Languages

Joshi Ashok and Brij Kothari

Working Papers | 2001

Same Language Subtitling: A Butterfly for Literacy

Pandey Avinash, Joshi Ashok, Takeda Joe, and Brij Kothari

Working Papers | 2001

Towards a Tariff Policy for Central Power Sector Utilities (PSUs) (Part I)

Sebastian Morris

Working Papers | 2001

Market Structure and the Demand for Veterinary Services in India

Cees de Hann, Dina Umali-Deininger, and Vinod Ahuja

Public provision of subsidized or free animal health services has been a major component of livestock development strategy in India. Overtime, the governments (both state and central) have built-up vast networks of physical and human infrastructure to provide these services to millions of farmers across the country. The number of state-run veterinary institutions had grown from about 2,000 in 1951 to over 50,000 at the end 1997-98. These institutions employed some 100,000 professionals and para-professionals. But, the quality of service provided by these institutions continues to be poor. Very few of these are equipped with clinical diagnosis facilities. Even those that have some facilities are very old. Lack of facilities for clinical diagnosis is at least in part responsible for indiscriminate use of antibiotics and anti-infectives, leading to high costs of drugs and medicines, and presenting a threat to human health because of the risk of inducing drug resistance.

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Working Papers | 2001

Economic and Policy Issues in the Livestock Service Delivery to the Poor

Elizabeth Redmond and Vinod Ahuja

Livestock are important to millions of poor households across the world not only as a source of income but also as a major source of protein and supplementary nutrition, draft power, fertilizer, fuel and a store of wealth. A large number of rural households across the world own livestock, the majority of them poor. A large majority of livestock owners comprise of small and marginal farmers, who also account for a large share of poor. In general, the distribution of livestock has been found to be more equitable than that of land, leading to a much more equitable distribution of gains from livestock production. This is specially true in subsistence economies with a predominance of smallholder production system. These are also the regions/countries with large concentrations of the poor where the depth of poverty is more severe, and where absolute poverty has shown a rising trend over the last few years.

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