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Swine flu stages a comeback in india with 345 cases reported in 7 days

With 345 cases being reported in the short span of 7 days, between 21st and 27th June, it has become clear that the arrival of monsoons has not only heralded the rains but also Swine Flu, in India! And with the virus spreading in areas, previously left untouched, this resurgence has become a matter of concern for the Indian Government.

A meeting called by the Indian government to discuss the country's preparedness to deal with a Swine Flu epidemic, the meeting headed by the cabinet minister saw them arrive to a conclusion that Swine Flu was to replace the seasonal influenza strain to become the dominant virus causing fever, cough and cold!

Dr. V.M. Katoch, ICMR director-general, who was part of the meeting, stated that there were bound to be more cases of Swine Flu in the near future, as it was spreading to areas where it had previously not shown of any signs of being active. For example, the state of Kerala which had reported very few cases of Swine Flu the first time round, now accounts for 266 cases out of the 345 cases!

However there is no need to fear yet, as Swine Flu is completely treatable....

To know more…click here  

Health insurance industry as early as 10 years back was in its infancy with only public sector companies who were also life insurance players.  It was after the year 2000 that privately owned general health insurance companies came to India like HDFC, Tata, Max life, Kotak and Birla but it was only in year 2005 with Star health that a dedicated health insurance company came in India. It was followed with Apollo DKV now known as Apollo Munich and now Max Bupa which has launched in March.

foreign health insurance companies are coming to India

There are more coming!

Max Bupa health insurance Company which is launched in March 2010 is a tie-up between Max health care and UK based Bupa. There is news that there will more 3-4 more pure health insurance companies that will come in the next few months. Most of these companies are international insurance

companies with a tie up with a company in India. Among these there is Discovery of South Africa and Cigna and Aetna of United States who are in talks with Religare for a tie-up. Some other international giants have also expressed their interest to form a joint venture with Axis Bank which is India’s third largest money lender.

What’s bringing them here?

population in india

K S Sankar of Medimanage Insurance Broking Private Ltd says, “The primary reason is the largeness of the market with low insurance penetration.” What with a middle class of about 300 million people and growing, and only about 10 % of Indian population covered in health insurance that leaves around a potential market of 270 million people. Sudhir Sarnobat, Founder of Medimanage agrees with Sankar and says it is the growing number of people who can afford health insurance which is driving this trend.

Just a look at the numbers tells the whole story, health insurance premiums amounted 66.25 billion rupees in 2009 from 32.09 billion rupees just two years back, it is more than 50% hike in just two years.

K S Sankar also points out that the health infrastructure in India, though unregulated is better than other economies in the world. He also gives other factors that make investing in India a good idea for foreign companies like better regulated insurance environment, lower capital investment requirement, smoother and relatively less corrupt processes with a population that is young hence a good risk and the factor that health insurance in India means only hospitalization costs that drop the overall costs considerably.

Mr. Sarnobat also sees an improvement in the industry that will interest the foreign players, “The premium rates are hardening which can provide a sound profitable business model for health insurance companies in next 3-5 years. These companies can bring in innovation in product structuring which is lacking in India and thus the heightened interest by foreign players.”

What will it mean for us?

Sudhir answers this question in two words, “Innovative products and better service.” K S Sankar feels that since these companies will solely concentrate on the health sector, their in-depth knowledge of health will help us. He says, “Their knowledge will initially make their processes more customer friendly and in the long run, rein in the health service providers from the perspective of cost standardization and right pricing of health services – not by sheer force of volumes but through more scientific benchmarking”.

Mahavir Chopra, founder of online health insurance broking in India, says "Customer will be spoilt for choice. The flip-side is there are chances he will get overwhelmed and confused. Brokers have an opportunity here. Look at a parallel of the now highly competitive cellular mobile service market, its pretty difficult to know which company or plan is good. Even though there is innovation, lack of any IPR on the innovation, results in the new service being copied by other companies in a couple days of the launch. Cellular service is almost a commodity."

Pashupati Davella, Insurance IT entreprenuer says, " Foreign players will bring process innovations so that the client can take treatment wherever he or she is, with minimum hassles. Also, because of greater integration between hospitals and insurers and reduced fraud, the cost of buying Health Insurance products go down and we may get long term care products, lifelong cover and features which are customer friendly like portability."

Currently in India, there is no standardization of health care cost, one procedure may cost Rs. 20,000 in one hospital and may cost over Rs. 50,000 in other. Mr. Sankar hopes that the ‘health only’ insurers will bring to the table independently validated bench marks.

Will they survive?

profits for health insurance companies

The scenario though seems to be very bright seeing the growth in premium, the reality is that health insurance is a loss making industry, the claim rate is about 120-150%. The underwriting losses of United India increased from 541 Crore last year to 880 Crore this year, a whopping growth of 63%. The reason why most of health insurance companies are still showing profits is that they have a life insurance subsidiary that is making money or if they have invested in the market.

K S Sankar also believes that it is the non-health insurance activities that will keep them running. He says of the purely health insurance companies in India; Star Health has been successful because it is sponsored by the government in some states. He points out that of Max Bupa, Max is already into Life and Bupa is primarily a service provider for international insurances and this combination again will have synergies to sustain them. “It is not without reasons that they did not rush in (before) but are coming in only now. All these players are using these models for immediate sustenance hoping right pricing of health insurance in India will happen sooner than later.”

Sudhir Sarnobat also feels that things will become better now, he thinks that as the premium rates are hardening, there is possibility of creation of innovative products in retail spectrum which can provide profits. He says “Till last year, the retail Health Insurance portfolio of all insurance companies was profitable hence, this business, if done properly, can provide profits.”

Last words

Having more dedicated health insurance companies in India means more good news than bad news to us- the end users, it means more choice, better service and better products and innovations in the field. “The more the merrier” says the Indian middle class customer, for sure!

air pollution leads to a rise in blood pressure

A new study has claimed that people living in areas with high levels of air pollution have higher blood pressure!

The study conducted at the University of Duisburg-Essen, Germany, found that long term exposure to high levels of air pollution not only increases the blood pressure of an individual and puts him at a risk of heart attack and stroke, but also acts as a trigger for many other underlying processes that lead to chronic cardio vascular diseases such as atherosclerosis –hardening of arteries.

The research lead by Dr. Barbara Hoffman was conducted for a period of over 3 years, analyzed the long term effects of exposure to pollution and found that high levels of air pollution lead to a rise in one’s blood pressure, irrespective of whether the subject smoked or his or her gender, age, weight.

To know more, click here…


Shortcuts. We use plenty of them on a daily basis; Shortcuts on our computers keyboards, shortcuts to reach our destinations early, shortcuts in our meals by opting for fast foods and so on... but are all the short cuts that we take healthy?

The answer is No! As not all shortcuts that we take are healthy, some shortcuts such as eating food past its expiry date to avoid going out and buying it, popping your mother’s sleeping pills to avoid going to the doctor and getting yourself a new prescription etc. may spell disaster for you health wise!

A fact discovered by a 39 year old Delhi Businessman who opted for wearing his contact lenses way past their expiry date to avoid buying new ones. The result was persistent redness and itchiness in his eyes, in fact he was lucky to have not permanently damaged his eye-sight as Rina Sethi, director, Arunodaya Desert Eye Hospital, Gurgaon, states that “Even when you clean and disinfect lenses and lens cases, they become coated with germs and protein over time. If you are lucky, you may develop just reddened, irritated eyes or a bacterial infection. But sometimes extended use may even lead to development of corneal defects like ulcers due to low oxygen permeability to the cornea…”

To know about more such detrimental health short cuts that might be taking, click here…


The Great Indian Guide for Baby Care - FAQsWe at Medimanage.com are pleased to inform you of the stupendous success achieved by the recently launched e-book on baby care titled ‘The Great Indian Guide for Baby Care’- a Medimanage.com initiative. This book can be personalized, downloaded or gifted to your near and dear ones for free from here!


1200+ downloads in a day - Thank you !


Following is a list of general FAQs regarding the download of the e-book, we hope these will answer all your queries.

Common Queries on the Download:

1. Why is a Login Access required to download the Book?

There are various instances where download requests could fail, due to a time-out or a pop-up blocker etc. The login helps us in saving your customized book under your login (explained in detail below)

2. I got "time out" error/Blank Page/Pop-up Blocker while trying to download the Book. How do I retrieve the Book?

In case you have got a Time Out/Blank Page/Pop-up Blocker after you clicked on Download e-Book, as mentioned above, we have saved the book under your login. Here's how you retrieve the book through your login.

Take the following steps:

- Log on to http://www.medimanage.com

- Click on the Login button on the top right

- Login with your username and password.

If you see the Member Central Dashboard:

a.  In the Left Panel, under Download Central – there is a link for Download Baby Care e-Book.
b.  This will take you the My Page
c.  Click the My Activities or My Purchases Tab.
d.  Click on the Link “The Great Indian Guide for Baby Care”. The book should start downloading.

If this does not work,

In case Internet Explorer : Right Click and select “Save Target As”.

In case of Mozilla : Right Click and select “Save Link As”.

In case you see My Page:
a.    Click the My Activities or My Purchases Tab.
b.    Click on the Link “The Great Indian Guide for Baby Care”.

If this does not work:

In case Internet Explorer  : Right Click and select “Save Target As”.

In case of Mozilla : Right Click and select “Save Link As”. 

3.  I saw the Insurance Store Page several times, after I provided my login information.
Sincere Apologies. You experienced a technical bug here. We have rectified the same. Request you to try downloading the book again we assure you that you will not find this error. Click here to download the book again.

4. I got a Server Error while downloading the Baby Care e-Book. 

Sincere Apologies. You experienced a technical bug here. We have rectified the same. Request you to try downloading the book again. We assure you that you will not find this error. Click here to download the book again.

5. Can you send the e-Book as an attachment.
It would be physically difficult for us to email each personalized book to your respective email addresses. As mentioned above, in case your download has failed, in most cases, the e-Book would have been saved under your Login. In case your Access Rights don't allow you to download the e-Book, request you to download the e-Book from an alternative computer (your personal computer, cyber-cafe's etc.) Lastly, we would request you to download the e-Book once again. We have tried our best to prevent any technical bug possible.

NOTE: You need to have Adobe Reader installed on your computer to be able to download/view your e-Book.

Thanks for the interest shown in the e-Book. Do send in your feedback/suggestions/inputs to the magazine@medimanage.com.

this world hypertension day know all that there is to know about hypertension or High BP

With the entire world observing 'World Hypertension Day' today, we are reminded that Hypertension or High BP still lives up to its 'Silent Killer' fame with almost 24-30% of India's urban population in its clasp.

What's more shocking is that, most of the individuals are clueless about their hypertensive state until it gets discovered in a routine check-up! Plus with the disease justifying its silent killer name by not showing any symptoms till it reaches an advanced state wherein it affects a person’s vital organs such as heart, kidney, liver, eyes and memory, which makes a BP check up necessary.

*A normal BP reading should read 120/80 with 120 being the systolic and 80 being the diastolic reading, one should always strive to keep their Blood Pressure close to the 120/80 margin or else they run the risk of a having a heart attack, stroke, vision loss and cognitive impairment*

To Know more about Hypertension, click here.

To get a different perspective on the possible causes of Hypertension, click here…

Fixed combination drugs provide the same results as basic drugs do, yet cost more! How would you feel if you went shopping for socks and the salesman sold you not only socks but shoes and shirt with it? Cheated, disappointed and angry right! Imagine the same scenario happening when it comes to your basic medicines.

What’s happening is that, the doctor’s these days are prescribing various fixed combination drugs (FDC) which cost considerably more than a basic drug, which would have had provided the same treatment effect to the patient! For e.g. Sumoflam, a combination drug consisting of paracetamol, nimesulide and serratiopeptidase which costs Rs 53 per 10 tablets is being prescribed for fever and Pain, when a simple paracetamol costing Rs 10 per 10 tablets, would have sufficed and given the same results as Sumoflam.

 With health care experts pointing out that most combinations have no medical logic whatsoever, it clearly seems like an attempt by the drug makers to exhort money from patients.What’s even more shocking about this whole nefarious affair is that certain FDCs also have side effects on vital organs, making it not only a costly but an unhealthy drug choice. This issue has bought to fore the desperate need for an unbiased flow of information to be provided to the doctors (private practitioners) about drugs, as their only source of information right now are the drug making companies themselves!

To know more, click here…

Nurses from Pooja Nursing Home with their gifts, courtesy Medimanage.com on the eve of International Nurses Day

Before we begin, we would like to ask a simple question to everyone “Do you remember the name of the nurse who helped deliver you as a baby?”

While we know that the question seems absurd, as one cannot be expected to remember a single random name after a gap of 10-20 years! But doesn’t it go to show how ignorant we are towards our nurses. While we may think that role of a nurse is not that important or vital, ask any doctor who is the most important person to him professionally and the answer will always be ‘Nurse’ or ‘Sister’ as they are sometimes known.

With nurses silently serving the society since time immemorial without due recognition, we at Medimanage.com decided to Thank the Thankless this International Nurses Day. The Medimanage Team visited Pooja Nursing Home, Mumbai on the occasion and spent time with the nurses while thanking them for their services. Speaking to them we realized the amazing dedication and passion these women exhibit towards their work, making the thankless scenario seem even more criminal, if we must say!

A member of the Medimanage Team presents a nurse from Pooja Nursing home with a gift on the eve of International Nurses Day

A member of the Medimanage Team presents a nurse from Pooja Nursing home with a gift on the eve of International Nurses Day



Exercise should be done to help with Osteoporosis

The discovery that you suffer from osteoporosis is obviously a sad and shocking one but it does not mean, that you stop moving at once! Sure your bones become weak and brittle and your chances of suffering a fracture go up suddenly, but did you know that there are plenty of exercises that help when one has osteoporosis?

“Exercise, when I have osteoporosis? Are you crazy!” is the usual reaction that follows whenever one is informed about possible exercises that help. Osteoporosis is a condition that results in the bones gradually becoming weaker, losing their density and becoming brittle. In such a condition weight bearing exercises such as walking, jogging, stair climbing etc, help build up bone density. One could also try their hand at resistance training, starting with light weights and gradually moving onto to heavier weights to build up bone density.

While one can always perform these exercises to help build bone density and reduce the chances of a fracture occurring, one also has to keep certain risk factors in mind which if controlled can lead to reduction in the chances of development of Osteoporosis.

To know more, click here…

First the good news, Indian health care industry in the 1990s grew at a rate of 16% and today is worth more than $ 34 billion. Health insurance industry has registered a 20% growth in health insurance premium in December 2009 and is expected to cross a premium mark of Rs. 9000 crore in FY 2010 making health insurance industry one of the fastest growing industries in India.

Now, a string of bad news, the average health expenditure on a person per year is just $34, only 6% of India’s GDP is spent on health, number of hospitals per 1000 persons is 0.7 while the world average is 3.9, less than 10% of India’s population has health insurance while 80% of health infrastructure is provided by private sector making health care unaffordable to most.

So the current scenario has a growing population, poor State-owned infrastructure, no health insurance coverage for the majority, and due to over dependence on private health care, exorbitant medical expenses. Over and above this, increasing migration of people from rural areas to urban areas along with adoption of sedentary lifestyles, poor dietary choices and stress has led to the spate of lifestyle diseases in India. Today, there are 51 million diabetics in India and the number is set to rise to 73.5 million by 2025. Similarly there are 25 million people with heart disease in India and 15 million die of this disease every year. While the number of cardiac patients is decreasing in the world, 60% of heart patients in the world will be Indians.

The news is indeed grim but the cause of worry is not only the rate of increasing diseases but also the nature of these diseases, diseases like Heart disease, Hypertension and Diabetes are chronic diseases requiring a long term medication course along with the set of complications that they bring requiring expensive treatments. With a large population of Indians - rich and poor - suffering from these diseases, the total healthcare costs will skyrocket. In this scenario, we asked health insurance experts about their thoughts about the future of health insurance industry.

We spoke to K S Sankar, Member of Corporate Relations, Medimanage, with about 30 years of experience in Health insurance industry and Sudhir Sarnobat, co-founder, Medimanage, a ‘health insurance broking firm’ with ‘dedicated India centric health website’ about the future of Health Insurance in India in relation with the increasing lifestyle diseases.

How to cover the masses?

Even with the tremendous growth in the health insurance industry we find in a country of more than one billion people only 9.8% of people have health insurance. This leaves 90 % of the population to either depend on the Government hospitals with subsidized rates or paying on their own the expenses they incur in private health care clinics.  With the public health care system failing, people have no choice but to depend on their own resources to pay for their health care.

Keys- Awareness and Affordability

K S Sankar says that health insurance can reach and cover the masses by being affordable and through awareness creation.  He believes the first goal is taken care of; “The industry has demonstrated capabilities of creating affordable products like Universal Health Insurance, Jan Arogya Bhima, etc. So, making affordable products available is not quite a problem. The problem has been that of creating awareness and reach”.

These health insurance plans do have some very good benefits at a low price. The Jan Arogya Bima Yojana for instance - in a premium starting from just Rs. 70, reimburses expenses upto Rs.5000 in a year towards hospitalization as well as pre and post hospitalization expenses.

The issue, therefore, is more about creating awareness of such policies.

Brokers should market Health Insurance

For the lack of awareness about the health insurance policies Mr. K S Sankar, says the fault lies with outdated model of marketing still used by the insurance companies. The only saving grace he says is “introduction of professional intermediation through insurance broking”. However he adds “even this was kind of forced upon the industry than happening as an internally evolved strategy”. But he laments that, the current breed of brokers, except a few, are more interested in reaching into each other’s market than genuinely trying to create more awareness and create new markets.

Using Technology for Volumes

The job of creating awareness he thinks should be primarily the responsibility of the State and health insurance companies.  The solution to the problem of reach, he feels, is to leave marketing of health insurance to the brokers, where the brokers choose to specialize in health insurance and hone their skills accordingly. And the key he feels is technology, he says “You find cybercafés even in C- towns. Even villagers are on to mobile phones and are used to ‘bill pay’s. There are more mobile phone users in India than health policy holders.” And thus he says, “Technology, at least in its elementary form, has reached out and just riding this reach would itself increase health insurance reach manifold.”

Lifestyle Diseases and How health insurance Companies can cope with them

 The recent health reports say that  India is about to become the diabetes and heart disease capital in the world, it would be important to know how health insurance is adapting to it.

Sudhir feels that Insurance companies have not really looked at the issue, neither as an opportunity nor as a threat. He feels that a system which rewards good management of health and reprimands bad management of health can help because these diseases can be managed by an individual. He suggests, “Insurers should be linking the premium to maintaining the Wellness Score like say, maintaining Sugar Levels under control, providing discounts in premium for better health etc. Insurers could also look at product innovation for specific diseases and thus spread the risk to improve performance.”

Keeping health insurance affordable

It is speculated that with more lifestyle diseases like Diabetes with no cure and many complications, the health insurance companies might just increase the premium or additional loading in the policy, making it unaffordable. K S Sankar disagrees with this approach. He opines, “Insurance is to cover risks, not to simply transfer the risk back to the original risk bearer. Making the risk bearer participate nominally in the claim is fine, but it has to stop there. Otherwise, insurance will become meaningless. So, hopefully there shall not be a late-in-the-day kneejerk reaction from insurance companies to lifestyle diseases in terms of controls, controls and more controls.”

Sudhir on the other hand, feels that as long as there are more people buying health insurance, health insurance will remain affordable. With increasing health costs, he feels there will be more focus on cost efficiency and hence there will be a closer examination of the hospitals by the Insurance Companies and TPAs.

Mr. Sarnobat provides various methods that could help reduce the costs, “Disease Management Protocols, Bulk Purchases of consumables, rationalization of medicine brands and gate-keeper mechanisms for selection of type of Healthcare Provider in line with the ailment profile will help to bring down the prices.” He feels that even if the premium rises, people would prefer to pay it rather than bear the costs, he sums it up by saying, “My take would be that for next 10 years, health Insurance will continue to be affordable as there is huge opportunity to increase penetration and cost inflation is not going to be in line with the same.”

Health insurance and Preventive Care

With lifestyle diseases on the rise and treatments available to cure them becoming more expensive, the only way to tackle this problem is to prevent lifestyle diseases in the first place. With almost all of the health care systems catering to curative methods of treatment, it is to be seen if health insurance companies do something in preventive health care. K S Sankar is of the opinion that there is now a change in perception and it is the private participation in healthcare that has brought the orientation towards pro-active health or preventive health. He feels that the impact of this orientation will take time but will lead the society to healthier living. However he feels that health insurance products are still oriented only towards curative health.

What can be done?

K S Sankar, feels that health insurance companies should build incentives to the section of the population that is health aware and compliant to healthy living processes. The specialized health insurance brokers referred above can greatly help insurers by tracking and reporting such compliance, both as a tool to the insured persons and as data to insurers.  He feels that health insurance companies should have a different pricing with incentive to those who ‘stay healthy’ rather than worry about those, who themselves spare no second thoughts to their health.

The way to do it         

Mr. Sudhir Sarnobat feels that before giving out a policy, the insurance company should determine the healthy living goals to be achieved and give benefits through discounts in premium or bonuses through increase in sum assured once the goals are achieved. This way you incentivize good health and thus reduce the claims in the long run.

Health insurance is sure to be a big industry in some time but it will only truly become a giant, if it looks at the challenge of low penetration, high claims rate, increasing lifestyle diseases and comes up with innovative solutions that make it attractive for the customer at the same time focusing on reducing the losses. The solution that comes across through the discussion is ‘preventive health care’ and if the Government as well as the health insurance industry focus on this part, health and cost of health care will no longer be a cause of worry for the customer or for the Insurance industry!





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