World AIDS Day: Victims continue to grapple with problems
Thirty-two year old Latha is a widow and HIV positive. Fighting back social stigma that is associated with people who are HIV positive, Latha’s never-say-die spirit has strengthened her will to live life to the fullest.
A clerk in a private firm, Latha has a life insurance policy to fall back on. She purchased the policy a year ago and also managed to take out one for her seven-year-old HIV positive son. With her meagre salary, Latha is determined to renew the policy next year, as it will ensure financial security if she is hospitalised.
Latha is among 2.5 lakh full-blown AIDS patients in Karnataka. Of these only a few thousands have access to life insurance. The reasons for this disproportionate access is not far to see. Most of the HIV positive patients belong to low income groups and consequently cannot pay the premium on the policies.
On the other hand, there are only two firms across the State who are into advancing life insurance to AIDS patients. The others are wary of even pushing policies to the patients since they know the policy holders would not be able to pay up the annual premium.
Of the two firms, take Star Health-Allied Insurance for instance. In 2008, Population Service International (PSI), an NGO, tied up with Star Health and Allied Insurance and launched Star Netplus policy. What started with 258 members has grown to over 1,000 PLHIVs in Karnataka.
PSI’s Atul Kapoor said, “The key barriers faced by insurance firms are that PLHIVs are a high-risk group and that adequate data about mortality and morbidity isn’t available.”
The policy is a group insurance having two criteria – 200 members in each group and CD 4 count of 300 at the time of enrollment. The premium for this cash-less hospitalisation scheme is fixed at Rs 1,500 per annum. The insurance provides Rs 15,000 for hospitalisation at any government hospital and another Rs 15,000 if the person is confirmed with full-blown AIDS. It also covers funeral expenses.
Many PLHIVs find it hard to pay the premium every month. Rangaraju from the Karnataka Network of Positive People (KNPP), said, “The PLHIVs have to pay Rs 755 a year. However, 40 per cent struggle even to pay for food. So the network tries getting local donors to sponsor part of the premium.”
Meanwhile, PSI is planning to include PLHIVs in Community Health Insurance (CHI) scheme and will launch pilot projects in Karnataka and Tamil Nadu by January. About 60 people have claimed CHI benefits over a span of six months till October.
L ast year, Karuna Trust along with National Insurance Company decided to integrate PLHIVs in its CHI scheme which currently has 188 members from 26 primary health centres (PHC), with nearly 55 per cent comprising women.
With a premium of Rs 25 a year, this scheme offers an exhaustive range of benefits. The cashless treatment includes 25 days of hospitalisation at any government hospital and gives the person Rs 100 as compensation for wage loss daily and to purchase medicines. Patients who require surgery are given Rs 500 each. Opportunistic infections like TB and other systems of medicine are also covered. Till now, 65 PLHIVs have claimed the insurance.
In all this, the government’s absence is glaring. It has the resources and power, but not the will. Even the PLHIVs aren’t very hopeful. “The Government won’t come out with any health insurance scheme for us. They haven’t even bothered to provide second-line ART treatment,” said Rangaraju.
Freedom Foundation, another NGO, had started a pilot project four years ago by enrolling 60 PLHIVs. However, it had to “foreclose” it within 13 months. “Insurance works in numbers. So working exclusively with PLHIVs isn’t very feasible for insurance companies. In fact, you have more money going out than coming in especially if the person is on ART treatment,” said the Foundation’s general manager Christopher Skill.
(Published in Deccan Herald on 30th November, 2009)