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What is health insurance?
Health insurance is when a person pays a fixed amount (premium) every year to an insurance company. In return, the company promises to pay for medical expenses if the person falls ill or needs hospital care.
The tug-of-war between hospitals and insurers is about money—hospitals want higher payments, insurers want to control costs, and the burden is falling on patients.
Health insurance is when a person pays a fixed amount (premium) every year to an insurance company. In return, the company promises to pay for medical expenses if the person falls ill or needs hospital care.
- What are hospitals asking for?
Hospitals say the cost of medicines, equipment, and staff has gone up. So, they want insurers to pay them more for each patient’s treatment. - What are insurers worried about?
Insurers collect money from people through premiums. But because medical bills are rising, they are paying out more claims than before. This reduces their profit, so they are resisting hospital demands. - Why are premiums for families increasing?
Since insurers are paying out more money, they are charging people higher premiums. For example, in recent years, the average family policy has gone up from about ₹8,700 to nearly ₹19,500. - What is a cashless claim?
In a cashless claim, a patient does not pay the hospital bill directly. The insurer pays the hospital. This is convenient for patients, but insurers complain that hospitals inflate costs under this system. - How does this fight affect common people?
Families end up paying higher insurance premiums. Sometimes, insurers delay or deny claims, and patients are forced to pay from their own pocket. Hospitals, on the other hand, refuse to reduce costs.
The tug-of-war between hospitals and insurers is about money—hospitals want higher payments, insurers want to control costs, and the burden is falling on patients.