Thursday, 6 August 2015

Health insurance project

On a rainy Monday, Harmonie and Maddy boarded the crowded blue bus bound for Dharamsala. Their mission for the day was to unearth information about health insurance policies that the internet could not provide. As the bus sped down the mountain they reviewed the plan for the day. First, they would visit the Zonal Hospital to research the RSBY Health Insurance Scheme. The Indian government provides a variety of programs that address health issues, but often citizens in poor, rural areas are not aware of these programs. EduCARE acts as an intermediary link between the government and community members to provide information and find beneficiaries. Second, they would visit New India Assurance, the insurance company designated by the government to provide health insurance to families living below the poverty line (BPL) in Himachal Pradesh.

These visits were the first step in finding affordable health insurance options for community members in Naddi. The health insurance project combines the project goals of Women's Empowerment, Health, and Microfinance. Providing affordable health insurance encourages regular visits to the doctor. Currently, in most homes, men's health is prioritized because they are the breadwinners. This means that many women suffer from chronic health issues that go untreated, because treatment is expensive and viewed as nonessential. Health insurance is not a traditional Microfinance endeavor, although EduCARE India does not take a traditional approach to Microfinance. Within EduCARE, Microfinance refers to small scale, community based enterprises, often focusing on financial inclusion. Affordable health insurance plans are a method of financial inclusion. Financial inclusion refers to increasing a person's documented financial activity and increasing their awareness of financial options available to them.

They entered the main doors of the hospital and explained they were looking to speak with Saroj Kumari about RSBY. This request began a fifteen minute race through the hospital from one room to another. As their guide led them at top speed through hospital hallways, patients looked on curiously, no doubtably wondering what the westerns were doing there. Though the hospital was crowded and there were patients waiting in all the halls, the two western interns waited no longer than three minutes to see anyone. They spoke with Ms. Kumari, a nurse responsible for RSBY patients. She explained that beneficiaries of RSBY would receive free health insurance if they were a BPL family. Next they travelled to a separate wing of the hospital, which was hot and humid with open windows and the distinct smell of cleaning bleach. The interns were rushed into an air-conditioned room to visit several doctors and important hospital personnel. The purpose of these visits were unclear and mostly involved chat about the weather. Eventually the interns found themselves sitting in the office of Dr. Gupta having a chai discussing EduCARE's mission, rural health, and the importance of health insurance. Dr. Gupta was very kind and answered all their questions in detail. They stayed to discuss India, France, the United States, and visas. After swapping visa stories, Dr. Gupta declared "In my experience, India is easy, a simple government and simple procedures for those who are honest". The interns disagreed.

As they walked out of the hospital, they felt fully prepared for their meeting at the insurance company responsible for insuring BPL families under the RSBY scheme. Soon they found themselves in the New India Assurance office listening to a story about a woman who had come to Kangra years ago working for an anti-deforestation NGO. This woman was Muslim and Caucasian, a detail that seemed to be the most important fact of the story, according to the teller. Roughly half an hour later it was revealed to them that there was no new information regarding RSBY that the office could provide.

All in all, the day was a mixed success, as is the case with most projects that set out to navigate and conquer Indian bureaucracy. It was encouraging to learn that NGOs have an important role built into the RSBY scheme, meaning EduCARE can positively effect the health of BPL families. Although, it was learned that BPL is a designation given by the head of a village and the government, which often means it is a relative title and excludes many families who are also in need of affordable health insurance. On the one hand, many of their questions were answered, but then on the other hand, with those answers come additional questions. At the end of the day, on the winding road back to Naddi, Harmonie and Maddy planned the next phase of their project, the mission to find affordable health insurance continues.

Maddy Kennedy - USA
Microfinance project manager

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