Genesis

“The poor themselves can create a poverty-free world… all we have to do is to support them in freeing themselves from the chains that they have put around themselves.”

-Professor Mohammed Yunus

Approximately one million people, mostly women and children, die in India every year due to inadequate healthcare. 700 million people have no access to specialist care and 80% of specialists live in urban areas.  In addition to the poor healthcare infrastructure, India faces a shortage of trained medical personal especially in rural areas.  The majority of the Indian population is unable to access high quality healthcare provided by private players, due to high costs.  Many are now looking towards insurance companies for providing alternative financing options to avail of better quality healthcare.

Health Insurance in India is gaining strength.  However, it will take a considerable number of years for them to reach about 200 million urban and rural poor.  Hence there is a need to design and implement innovative schemes to suit the socio economic conditions of the urban and rural poor in India. 

Dr. Arjun Sachidanand, MBBS, MS and MBA in hospital and healthcare management, studied the health insurance systems in India and abroad for 2 years. He found that the premium for the health insurance schemes of the private sector is not affordable for the poor.  The Government sponsored health benefit schemes have low or no premium, but do not cover many common diseases. There are many difficulties for the poor in accessing healthcare services in recognized hospitals and for the hospitals in getting reimbursement of claims.  He realized the need for developing high tech software to address the issues relating to approval and settlement of claims and better systems in providing healthcare to the poor. 

He developed a web based software and designed an innovative health scheme to benefit a large number of urban and rural poor families by providing them low cost hassle free healthcare by collaborating with Non-Governmental Organizations and network of selected hospitals. 

To implement the scheme, a private limited company called SAS Poorna Arogya Healthcare Pvt. Ltd.(‘SAS’), was registered in Jan 2010, under the Indian Companies Act 1956, with Dr. Schidananda Murthy as Director and Dr. Arjun Sachidanand as Managing Director. SAS manages provision of all healthcare services including identifying network hospitals and processing of health benefits to members.

To ensure the scheme complies with all regulatory requirements, a Charitable Trust called Samyukhta Swayam Seva Samsthe (‘Health Trust’), was registered in 2010, with Dr. Schidananda Murthy and Dr. Arjun Sachidanand as Trustees. The Health Trust manages the ‘Health benefit Fund’, created by collecting membership fees, to pay for all healthcare services.

Under this scheme NGOs /NGO-MFIs /Cooperatives are encouraged to partner with the Health Trust and issue Health Cards to their urban and rural beneficiaries, most of whom are poor.  The local hospitals sign agreements to be part of the network and provide healthcare/medical services to the card holders.

The Scheme was inaugurated with Kadamba Foundation based in Uttara Kannada district, in the first quarter of 2010.