Medical Insurance Subsidy

Exactly a year back my mother was in hospital. She was there for three weeks before she died. The bill for the three weeks came to close to four hundred thousand rupees. She was covered under my corporate medical insurance so I passed on the cost to the insurer, who paid most of it. I didn’t really complain, the insurer was obliged to pay, and the hospital was more than happy to receive the fee.

The hospital follows an interesting business model. On one hand it dons the garb of a corporate hospital while on the other it is a charitable hospital. A large section of the patients are treated at extremely low cost, or even for free. The rest of the patients have insurance coverage. Those that have coverage are fleeced, and this money effectively cross-subsidizes the treatment of the poor. All works out well for the hospital. Except..

Do you realize that when you (or, in most cases, your employer) pay your premium for medical insurance you’re not insuring just yourself? That because of hospitals like I just mentioned, your insurance is also effectively paying for the treatment of a larger population? That the cost of treating some random patient in the hospital you were admitted to is paid for by you, as part of your medical insurance premium?

Changing tracks, I think the best thing about India’s healthcare industry is the diversity. You have government hospitals. There are university hospitals. There are large corporate hospitals you wouldn’t think of stepping into unless you had insurance. There are charitable hospitals which treat you for next to no cost. There are the neighbourhood nursing homes which essentially cater to the uninsured middle class. Reasonable facilities but not too expensive. And so forth.

There is no formal system of medical insurance in the country. There is no single large government system. If the current state of healthcare in the country is one of not having evolved much, I really wouldn’t mind it remaining this way. I hope we never get into the kind of equilibria that the US and the UK have gotten themselves into, which appear efficient but which ultimately prove expensive for people.

It is the diversity in the system that keeps the healthcare industry here competitive, and keeps costs low. And of course, you pay for other people too when you pay your medical insurance premium.

Business Model for DD

Flipping channels an hour back, I happened to stop at this never-heard-before channel called “DD Bharati”. Usha Uthup was giving a concert that was ¬†clearly recorded for television. Looking at her, and considering that the program had been recorded in black-and-white film, I would suppose that it was ancient indeed. Maybe from some time in the 70s.

The program itself was nice. The sets, for the time, were excellent. Usha was backed up by a bunch of men clad in suits – one on keyboard, a couple on guitars, one on trumpet, one drumming, one on the cymbals and another just swaying from side to side. The songs were all quite good, most of them Usha’s own compositions, and I didn’t think twice about giving up on ESPN Sportscenter Asia, Roland Garros and three not-so-bad Hindi movies in order to watch this program. And while I was watching I thought of this business model for Doordarshan.

The basic idea is that there is a whole lot of footage – all that was shown all through the 70s and 80s – that is quite popular among people and nostalgia-inducing, which is held by Doordarshan. I would be surprised if DD would have licensed out any of its old content to any other channel, if not for any other reason but because so much bureaucracy would have to move for that to happen. Stuff like 80s soaps and sitcoms, shows like the Usha Uthup performance I watched today, etc.

So I think DD can truly profitably run a “nostalgia” kind of channel. The market of people who grew up on these programs in the 70s and 80s is large, and most would prefer to watch re-runs of those ancient shows rather than watch the tripe that is dished out by most channels today. And then there is an opportunity for people to catch up on stuff they missed out on back then for various reasons – for example I missed out on so many cool programs back in the late 80s because our antenna didn’t catch DD2, and I wouldn’t really mind watching those today.

And then those ads – yeah they are available on youtube (and on dd’s own site) but then I’m sure it would be profitable to run those ads now as programs in themselves! The opportunities, I think, are endless. Unfortunately it is a sarkari company that is not interested in profits that is sitting on all these options. The loss, I think, is for us potential viewers.