Goa: Health Care Financing

Group (HE):
Dr Satish Tajne
Dr Gitesh Shelar
Dr Shweta Sharma
Dr Shilpa Jain
Dr Shekhar Gaddam
 Introduction
• Goa is one of the smallest states in India located on the west coast between
Maharashtra and Karnataka.
• After liberation in 1961, Goa was a Union Territory until 1987 when it
achieved status as the 25th state of India
• In the 2001 census, Goa had a relatively small population of just 13.5 lakh.
Goa’s population is predominantly Hindu (64%) and Catholic (31%).
• Goa is already one of the most urbanised states in India (51% vs 26% for
India).
• As compared to India as a whole, Goa shows remarkably higher human
development indicators.
Goa India
Literacy rate,
82% 64.8%

• Economic indicators are also much stronger in Goa than most parts of
India. Thus, housing conditions are less crowded and majority of people
have access to electricity, television and radio, and newspapers.
• Goa’s economy is dependent on 3 major factors, Viz., mining, tourism and
agriculture (including fishing).
 Health system & services
• Goa has one of the most extensive health systems in India.
• The public health system includes higher training institutions for doctors,
dentists, pharmacists and nurses.
• Two major district hospitals Asillo in Mapusa (north) and Hospicio in
Margao (south), with the Goa Medical College Hospital (Bambolim)
comprise the main secondary and tertiary referral hospitals for the state.
• There are nearly 4 hospital beds for every thousand people in the state (as
compared to 4 beds for 6000 people in India as a whole).
• Health care is available near people’s homes as a result of an extensive
network of Primary Health Centres, Community and Urban Health
Centres and 27 Rural Medical Dispensaries.
• Special hospitals are available for the care of severely mentally ill and
tuberculosis and chest diseases.
• There is more then one doctor for every 1000 persons living in Goa, as
compared to less than one doctor for every 2000 persons in the rest of the
country.
Demographic, Socio-economic and
Health profile of Goa
Immunization
 State/ut wise allocation under health
sector in 10th plan 2002-07 n expected
2007-08
2002-07 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08

Goa 13135.0 1888.48 2568.54 3149.21 2568.54 4495.00 16587.0

Delhi 238150 33043.4 38942.1 46989.1 38942.1 69120.0 99500.0

D&N 1225 269.57 301.67 403.20 301.67 470.0 663.00
haveli
Daman & 1750.0 201.68 282.85 301.03 282.85 414.0 413.0
diu
Lakshadw 901.3 232.33 228.24 166.73 264.90 17800.0 440.00
eep
Puducher 16360.0 3000.21 3259.04 4196.59 3259.04 9485.00 13585.0
ry
Assam 57069.0 8194.35 7631.46 6529.0 7882.00 … 13532.0

Chandigar 22426.0 3944.93 3546.75 3355.33 3546.75 3587.00 …

h
 State Initiative
• Medical Reimbursement:
• The Government of Goa along with the New India Assurance Company in
1988 developed a medical reimbursement mechanism.
• This scheme can be availed by all permanent residents of Goa with an
income below Rs 50 000 per annum for hospitalization care, which is not
available within the government system.
• The overall limit is Rs 30 000 for the insured person for a period of one year.
• Mediclaim:
• Goa is the only state providing mediclaim
scheme under which financial assistance to every
citizen of Goa for super specialized treatment,
that is not available in Goa, is provided.
• Those having 15yrs residence in goa and whose
HH income is less than 1.50 lakh can avail this facility.
• Financial assistance is Rs 1.5L in all cases except,
for kidney transplant, neuro surgery, heart surgery
it is 3L and for cancer it is 8L.
 Recommendations for the Future
• Partnerships between sectors:
 Partnerships for health imply that health is not the domain of professionals alone,
but is a fundamental right of each member of the community.
 Partnerships are essential between the public and private medical sectors, between
medicine and other disciplines, between industry and voluntary organisations.
 At the level of governance, partnerships are essential between all departments
with the health department.
 In the long-term, innovative financial partnerships between the government,
private providers and medical insurance firms may provide a cost-effective way
of delivering quality health services to the entire community by reducing
competition and duplication between providers, allowing greater monitoring of
quality and enabling investment in public health programmes.
• Public Health Monitoring Group:
 Health is a core aspect of any development activity, whether it is tourism,
construction, mining or roads.
 At the heart of this philosophy is that all development must be people-
centred.
 The establishment of a public health monitoring group, with
representatives from all sectors of society, will be a useful way of ensuring
that a health dimension is always considered in major policy issues in Goa.
• Improving quality of health services:
 It is essential for doctors to recognise the important role they play in
health.
 Doctors and nurses in the public sector need to recognise that
compassionate and sensitive communication is the key to generating
respect and improving health outcomes.
 Tighter regulation of nursing homes may include regular visits by the
monitoring team to ensure good practice.
 Public health monitoring group could play an important role in ensuring
standards of care in both public and private health care.
• Improving working condition for non-medical health workers:
 It is essential to improve the working conditions of professionals such as
nurses and rehabilitation therapists in order to attract more candidates to
these professions.
 The imbalance in numbers of doctors and other health workers requires
correction to ensure that public health programmes are implemented.
• Greater support to the weak and marginalized: Some groups in our
community, such as migrant workers, elders and the disabled, need special
attention because their health needs may differ from the rest.
• Research &Training:
 Systematic documentation and research is needed to define our health
needs in less understood areas such as road accidents, mental disease,
school drop-out, heart disease and health economics.
 Their primary tasks must be to provide high-quality tertiary medical care
and become centres of excellence for training and research.
• Extra Taxation on Alcoholic Beverages: 2% tax on liquor beverages so
that income incurred from it can be invested in health services.