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Birth defects find no place in health insurance plans

KOCHI: Even as cost of health care in the private sector shoots up considerably, birth defects are not covered under the existing health insurance schemes which make it financially burdensome for parents to treat their children with such defects. On the other hand, in the case of carrying mothers, the insurance companies charge hefty premium to cover the baby as well, according to pediatricians. “If a baby is covered under an insurance scheme and a defect is detected after that, the insurance companies seek an explicit statement from the parent that the defect detected in the child is not a birth defect,” says Dr R. Krishna Kumar, pediatric cardiologist with Amrita Institute of Medical Sciences (AIMS).

“Because of this situation, parents find it very difficult to raise finances for surgeries like cardiac surgery,” he says.  “The most common defect among babies occur in heart. The cost of heart surgeries is in the range of Rs 1 lakh to Rs 2.25 lakh. Many are forced to sell ornaments, mortgage properties and take other such measures to raise money for the surgery,” said Dr Krishnakumar.

According to Prema Sagar, founder trustee, Genesis Foundation, a non-profit trust, corporates very rarely come forward to support healthcare of underprivileged children as part of their Corporate Social Responsibility (CSR) initiative. “They would sometimes say okay for initiatives related to nutrition, otherwise their focus is on education. It is high time the lives of critically ill underprivileged children are saved with their support,” she said.

Dr Krishna Kumar said that eight in 1000 babies born in the country have heart diseases of which three are critically ill. “Kerala is much better in giving care to these children while many states do not have even pediatric cardiologists, especially in the north-east. In fact 99.7 percent children can survive if timely treatment is given,” he said. Ms Prema Sagar says that the number of hospitals for pediatric surgeries is limited in the country and they have long waiting list of patients also. “The sector needs government care and expansion,” she said.

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