With the surge in the demographic and epidemiological transition in today's era, cancer is considered an emerging significant public health concern in India. The cancer development among individuals affects the individual's body and mind and disrupts the financial aid of the individuals and their families. The aetiology of cancer and its epidemiology has received significant attention from researchers and policymakers1. Cancer is considered the second leading cause of death across the globe and has accounted for 13% of total death rates2. The prevalence of cancer proved to be evident within developed nations but also increased significantly in developing countries.
The Global Burden of Disease (G.B.D.) has recommended that approximately 70% of all cancer deaths have been predominantly found within low and middle-income countries (Dinshaw et al., 2005). Therefore, cancer and research treatment have been known to be one of the most challenging domains within the biomedical sciences and oncologists are still struggling to ensure greater survival chances in most cancer patients. Approximately 60% of the mortality rates due to cancer can be prevented with improved preventive and screening facilities3. Most of the cases of cancer survival are concerned with early cancer diagnosis, and easy access to state-of-the-art medical technology is considered a prominent policy concern for low- and middle-income countries. The issue increases for developing countries such as India due to its poor geographical coverage of medical services and very little financial protection in health.
More than 75% of cancer care costs in India are paid out of pocket. There is very little insight regarding the complexities and structural issues while emerging economies in Indian states deal with affordable cancer care and control systems. Hence, the need for reasonable cancer care in India requires a proper understanding of significant differences in health spending across individual states and union territories and the gaps in fundamental health indicators and outcomes. General health insurance and even the most comprehensive plans cannot provide individuals with full treatment benefits for cancer. Hence, there is a need to acquire critical illness coverage for the same.
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The reports have revealed that almost less than 20% of the individuals in India are covered under health insurance. Approximately 80% of the Indians are still not assured regarding the benefits of the health insurance and other beneficial schemes provided from the Government's end. According to the report of the World Health Organisation (WHO), approximately 10 lakh new cases are reported in India every year. The annual death rate of individuals due to cancer in India is estimated at nearly five lakh individuals, and WHO predicted the number to rise drastically up to seven lakhs in the year 2015. The incidence showed an immediate five-fold surge by 2025, and the prevalence of the same is increasing to 19% among men and 23% among women by the year 2020. Only 7.1% risk of cancer deaths is estimated before the age of 75 years as per the reports of Globocan 2012, an international cancer research project; insurers claim that one in five cancer claims is by those between 36 and 45 years of age. It reveals that the disease has disrupted the family's finances due to the loss of income source.
Cancer care has a long-term effect on an individual's finances, which most often translates into a recurring expenditure. It leads to a substantial financial burden on the family, buying health insurance. Almost 70% of the cancer cases in India are detected at the advanced stages. Hence, the direct approach of the patient with their oncologists while reaching the advanced stage of the disease results in increasing the cost of the treatment and survival to be less likely. The average price of the cancer treatment under a private practitioner usually involves the cost reaching up to Rs 5-6 lakhs, including investigations, surgery and radiotherapy. However, when opting for the targeted therapy, six cycles of chemotherapy cost up to approximately Rs 20 lakhs. These increasing costs of medical treatment and the spiralling cost of treating significant ailments and surgeries with inappropriate and no availability of health cover results in the financial and mental status of the individuals. Hence, there is a need to adhere to the insurance policy and schemes, which reduces the financial burden during cancer treatment.
Also Read: Cancer Treatment Cost in India
Some government schemes for helping patients by providing financial support to cancer patients have been discussed below:
1. Health Minister's Cancer Patient Fund (HMCPF): The government scheme offered by the Ministry of Health & Family Welfare under Rashtriya Arogya Nidhi to provide financial support to patients belonging to the below-the-poverty line. It was initially started in the year 2009. The utilization of the Health Minister's Cancer Patient Fund integrates the establishment of the Revolving Fund under R.A.N. within 27 Regional Cancer Centres (R.C.C.s). This significant step helps ensure and speed up the financial assistance to needy cancer patients and helps them fulfil their objectives of HMCPF under R.A.N. This scheme usually provides financial support up to Rs 2 lakhs and Rs 5 lakhs in emergencies to cancer patients, which is processed by Regional Cancer Centres (R.C.C.s). The particular individual cases that require the financial support of more than two lakhs are passed on to the Ministry for processing. The Revolving Funds have been generated in all 27 Regional Cancer Centres (R.C.C.s) and up to Rs. Fifty lakhs will be placed at their disposal. The Revolving Funds will be replenished on fulfilment of conditions regarding the submission of the utilization certificate and list of beneficiaries. Some of the guidelines for applying for the Health Minister's Cancer Patient Fund (HMCPF) are discussed below:
2. The Health Minister's Discretionary Grants (HMDG): It is the type of scheme that provides financial support of up to Rs fifty thousand to poor cancer patients in conditions where these patients are not able to avail accessible medical facilities at the government hospitals. Only those cancer patients who have an annual income of up to Rs.1.25,000 and below are eligible for financial assistance of up to 70% of the total bill.
3. The Central Government Health Scheme (CGHS) applies to retired Central Government employees and their dependents. To provide better cancer treatment facilities to CGHS beneficiaries, one private hospital in Hyderabad and 10 Private hospitals in Delhi were registered in June 2011 under CGHS, mainly for availing Cancer treatment as per the rates of Tata Memorial Hospital for Cancer Surgery. The patients are eligible for availing of cancer treatment at approved rates within any hospital that constitutes several cancer treatment options.
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4. Prime Minister's National Relief Fund (PMNRF): It mainly aims to provide financial support to the poor patients for the disease treatment at Government/PMNRF designated hospitals to the partial settlement of the expenses. The patients are eligible for the grant of financial assistance through an application addressed to the Prime Minister. Disbursements are integrated at the sole care of the Prime Minister, keeping in view the availability of funds and previous commitments of the PMNRF. It is applicable for the victims of natural disasters and also provides partial coverage for heart surgeries, kidney transplantation, cancer treatment, and more such treatments.
5. Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme or Ayushman Bharat Yojana (AB-PMJAY scheme): It is known as the flagship National Health Protection Scheme being funded by the Government of India. It, also known as Ayushman Bharat Yojana, aims to cover up to 50 crore citizens of India constituting rural and urban regions of the country. It is one of the biggest healthcare schemes being sponsored by the Government of India. Ayushman Bharat Yojana (AB-PMJAY) will help underprivileged families avail the best healthcare services with insurance coverage of up to INR 5 lakh for each family per year for tertiary and secondary hospitalization expenses involving diagnostic costs, medical treatment, hospitalization, pre-existing illnesses and several critical ailments. It facilitates cashless healthcare services to its beneficiaries in public sector hospitals and private network hospitals.
6. State Illness Assistance Fund (SIAF): It is mainly integrated for the specific states and union territories for setting up the Illness Assistance Fund offering coverage of up to Rs. 1 Lakh for cancer treatment at government hospitals within the state. Many states do not constitute this scheme, while other states support the plan.
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