The Working Committee on Health Insurance constituted by the Insurance Regulatory and Development Authority (IRDA), New Delhi is actively considering a proposal to enable the four state-owned insurance giants to extend Mediclaim coverage to pre-existing illnesses.

The issue came up at the first meeting of the committee held in Delhi earlier this month, and may be further developed at their next deliberations, scheduled for November.

Also discussed at the committee meeting was the likelihood of setting up a regulatory board to help standardize crucial policy decisions with regard to the health insurance sector.

Revealing details, S K Mahapatra, secretary general of GIPSA told Pharmabiz.com that the Indian health insurance is devoid of any regulatory mechanism, which is an essential tool while designing any new policy. Lack of data, no standardization principles, no classification and grading practices and no accreditation, further dampen attempts made by the Centre in making health insurance reachable to the masses.

"Till today there does not exist a single source from whom we could procure adequate data in strengthening our policy-making decisions. At times, doctors and consultants who are responsible in implementing cashless policies are themselves reluctant to share data. This is also an other reason why foreign insurance players are running away from the Indian market," averred Mahapatra.

Stressing on the need for evaluating clinical data, Mahapatra noted, "Consultants are busy levying fees according to their whims and fancies. The same consultant who practices in suburbs charges less amount for a particular procedure and has a different fee structure when he practices at urban towns, how can this be justified. They need to have a stable structure to make services affordable to all," said Mahapatra.

According to Mahapatra, the IRDA-backed committee would be meeting next in November this year where a partial decision would be taken on the steps and procedures to be staged for effecting setting of the new regulatory board and for rolling of the changed Mediclaim scheme.