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India Aims for the World's Biggest Health Care Overhaul

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Re: India Aims for the World's Biggest Health Care Overhaul

#61

Post by shripadk »

PeterisP wrote: post #2

The math doesn't check out. "Each family would get more than $7,200 in annual coverage"; "better health care for 1.3 billion people" and "Modicare is expected to cost the Indian government less than $2 billion annually" seem to be mutually exclusive. There's no reasonable way for health insurance/coverage to be so underutilized that on average only $1-$2 of $7200 would get used.

Why is this so hard to understand? Why would 1.3 billion people want $7,200 in coverage at once? If that happens then it's a mega catastrophe of proportions that the entire World would not be prepared to bear. That would also mean the end of the World as we know it.

So let's be realistic shall we? Of those 1.3 billion people hardly 0.1% of them might fall ill in any given year. That's 13 million people. That's still a huge number. Of them how many do you think would be critically ill? 100%? 75%? 50%? 25%? Let's take 25%. That would still be a huge number of critically ill patients (3.25 million). The total number of cancer patients in India per year is around 7 lakhs, which is 0.7 million (http://cancerindia.org.in/statistics/) so my guesstimate of 3.25 million makes sense (even though I feel it's higher then what the actual stats are). Only such kind of people would need the $7,200 insurance because critical illness care is cheaper in India compared to any other country. You don't need $7,200 to treat malaria or flu or to get your wisdom tooth removed (https://timesofindia.indiatimes.com/city/ahmedabad/Wisdom-li...). You need that kind of amount if you get cancer/stroke etc. Of those 3.25 million patients what percentage do you think are people who can afford private healthcare and those can't? Of those who can afford how many of them are covered by their employers group health insurance or have their own insurance purchased as part of tax saving initiatives? Now you do the math and you'll get your answer.

Re: India Aims for the World's Biggest Health Care Overhaul

#62

Post by [deleted] »

PeterisP wrote: post #60
thatfrenchguy wrote: post #36

Earlier quoted context omitted.

Coverage up to X does not mean people will use X. 7200$ is a shit ton of money in India.

Sure, people will not use X but they'll also use more than 0.02% of X; Even a ridiculously unrealistic low utilization of 0.2% is 14$/year and would cost ten times more than the "estimated" cost.

[deleted]

Re: India Aims for the World's Biggest Health Care Overhaul

#63

Post by shripadk »

PeterisP wrote: post #60
thatfrenchguy wrote: post #36

Earlier quoted context omitted.

Coverage up to X does not mean people will use X. 7200$ is a shit ton of money in India.

Sure, people will not use X but they'll also use more than 0.02% of X; Even a ridiculously unrealistic low utilization of 0.2% is 14$/year and would cost ten times more than the "estimated" cost.

No they won't. You aren't discounting those who already hold health insurance because it's a deduction for their tax returns. So for such people it's an investment. You are also not discounting those who are covered by their employers group health insurance. Not to forget those people who already have enough to spend for private healthcare. Not all 1.3 billion people in India are poor who depend on government health insurance.

Re: India Aims for the World's Biggest Health Care Overhaul

#64

Post by shripadk »

balladeer wrote: post #22
PeterisP wrote: post #2

The math doesn't check out. "Each family would get more than $7,200 in annual coverage"; "better health care for 1.3 billion people" and "Modicare is expected to cost the Indian government less than $2 billion annually" seem to be mutually exclusive. There's no reasonable way for health insurance/coverage to be so underutilized that on average only $1-$2 of $7200 would get used.

You should hear our respected PM's (PM Modi) speeches (pick pretty much any) and ruling party's (BJP) statements and you would get used to math and facts not checking out. I used to think those were just slips and mistakes. It took a couple of years for me to finally understand that those were indeed mistakes but "calculated" ones. It works like this - you declare "every household will get X by the end of 3rd year" a…

Can you explain what is wrong with the math here? Are you expecting 1.3 billion people to fall ill every year? This is coverage we are talking about. I can't understand how some people don't know what coverage means.

Re: India Aims for the World's Biggest Health Care Overhaul

#65

Post by blinkingled »

pcrh wrote: post #49
petilon wrote: post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

There is merit in having a deductible, however there are several ways in which this system is flawed. First, employers should be out of the healthcare equation entirely, except in as far as either taxes or salaries are used to fund health costs the employee bears. After all, employers don't participate in many other common expenses people bear, from housing to educating their children. Second, individuals are general…

> First, employers should be out of the healthcare equation entirely,

This. A million times. If there's one thing that's bugged me a hell lot as an immigrant in the US it is this. It's insane to give employers control over something as personal as your healthcare. I have been lucky enough not to have major issues with this arrangement but I have heard far too many horror stories from colleagues.

Re: India Aims for the World's Biggest Health Care Overhaul

#66

Post by vthallam »

pavanred wrote: post #52
thevardanian wrote: post #38

Earlier quoted context omitted.

What are you talking about? There are very few metrics that you can list that show a decline. So how about you show me the data for decline.

How about freedom of press as an example (World Press Freedom Index) 2018: 138 2017: 136 2016: 133 A good rule to follow, formulate an opinion after you gain enough facts to argue the other side, else you'll keep seeing only what you want to see.

You can't pick one index to your convenience and even then, I have looked at the website - https://rsf.org/en/india which I think is your basis of the rankings.

Their headline was > Deadly threat from Modi’s nationalism

Scaremonger much? I don't buy the fact that in the Internet age, you have to be some reporter to write against the government policies. If someone has any groundbreaking evidence against anything wrong the government is doing, all it takes is one youtube video anonymously.

They rank the United States at 46, the United Arab Emirates at 128(better than India) and India at 138. Seriously? There has been a mention of 3 isolated incidents against journalists who were affected. All these are criminal incidents where the police have started investigating, just like the thousands of criminal incidents against ordinary Indians.

There has never been a prime minister who was hated this much by an Opposition and god forbid there will never be. I really hope the opposition in India talks about development than scaring ordinary citizens, after 4 years of peace, you can't scare them.

Re: India Aims for the World's Biggest Health Care Overhaul

#67

Post by PeterisP »

shripadk wrote: post #63
PeterisP wrote: post #60

Earlier quoted context omitted.

Sure, people will not use X but they'll also use more than 0.02% of X; Even a ridiculously unrealistic low utilization of 0.2% is 14$/year and would cost ten times more than the "estimated" cost.

No they won't. You aren't discounting those who already hold health insurance because it's a deduction for their tax returns. So for such people it's an investment. You are also not discounting those who are covered by their employers group health insurance. Not to forget those people who already have enough to spend for private healthcare. Not all 1.3 billion people in India are poor who depend on government health…

These factors don't need to be explicitly discounted because they are far too small to matter. The number of people covered by various private group health insurance in India is something like 100 million, so it's just a 10% difference when we're talking about order-of-magnitude differences. Yes, not all 1.3 billion are poor and depend on government health insurance, but the numbers are so outrageously off that it doesn't work for 1.3 billion people; doesn't work for 1.0 billion people, doesn't work for 0.8 billion people (who are currently uncovered by other gov't subsidies including RSBY). Unless you're arguing that it applies to a tiny, tiny fraction of Indias population, the math doesn't work out, either the cost estimate or the benefits will be entirely different.

Re: India Aims for the World's Biggest Health Care Overhaul

#68

Post by trumped »

petilon wrote: post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

Terrible idea. The $6000 should instead be a percentage of your income (above a certain point, like poverty)... i.e.: ($60,000 - $12,000) * 0.05

Re: India Aims for the World's Biggest Health Care Overhaul

#69

Post by PeterisP »

shripadk wrote: post #61
PeterisP wrote: post #2

The math doesn't check out. "Each family would get more than $7,200 in annual coverage"; "better health care for 1.3 billion people" and "Modicare is expected to cost the Indian government less than $2 billion annually" seem to be mutually exclusive. There's no reasonable way for health insurance/coverage to be so underutilized that on average only $1-$2 of $7200 would get used.

Why is this so hard to understand? Why would 1.3 billion people want $7,200 in coverage at once? If that happens then it's a mega catastrophe of proportions that the entire World would not be prepared to bear. That would also mean the end of the World as we know it. So let's be realistic shall we? Of those 1.3 billion people hardly 0.1% of them might fall ill in any given year. That's 13 million people. That's still…

"hardly 0.1% of them might fall ill in any given year" is a very unrealistic assumption - is service is available (which is not universal in India at the moment, but is promised to be with this reform) the expected number of annual per capita doctors visits is at least 1 (OECD country average is 7, poorer countries get 1-2), not 0.001, a thousandfold difference. Not all people won't get ill in a given year, but a large portion does; it depends on how severe illnesses you count but it's 30-60%, not 0.1% or 1%; and some people (much more than 0.1%) get multiple illnesses in a single year.

I'm arguing that on average people (all 1.3 billion of them) need much, much more than $1 of coverage each year. You don't need $7200 to treat common diseases, but many of them will need more than $1. For every person that needs $0 of coverage there will be one that needs more than $2.

If the estimate was comparable to $10 per person (so, excluding private insurance, roughly $10 billion total not $1-2 billion), then it might be worth starting a discussion about the details and how much what costs. But $1/person/year is so ridiculous that it's off the charts.

Re: India Aims for the World's Biggest Health Care Overhaul

#70

Post by [deleted] »

PeterisP wrote: post #67
shripadk wrote: post #63

Earlier quoted context omitted.

No they won't. You aren't discounting those who already hold health insurance because it's a deduction for their tax returns. So for such people it's an investment. You are also not discounting those who are covered by their employers group health insurance. Not to forget those people who already have enough to spend for private healthcare. Not all 1.3 billion people in India are poor who depend on government health…

These factors don't need to be explicitly discounted because they are far too small to matter. The number of people covered by various private group health insurance in India is something like 100 million, so it's just a 10% difference when we're talking about order-of-magnitude differences. Yes, not all 1.3 billion are poor and depend on government health insurance, but the numbers are so outrageously off that it do…

[deleted]
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