Que: Should lung-related diseases be covered under an insurance

policy? Would your answer vary if it were social insurance versus

private insurance? Discuss how the nature of health shocks affects the
design of health insurance. How should health systems deal with health
shocks such as COVID19?"

We, intentionally or unintentionally, expose our lungs to a variety of hazards. This begins at
a very young age when our bodies are still quite vulnerable to harm. Furthermore,
respiratory infections are linked to some of the most frequent human illnesses.

The three main types of lung diseases are airway, lung tissue, and lung circulation diseases,
which have a significant impact on the organ's ability to perform the process of respiration
and can be caused by the presence of factors such as (but not limited to) comorbidity,
immunity against respiratory ailments, substance abuse, tobacco usage, working
environment. There are various parameters like causes, mortality rate, and treatment costs
based on which these diseases can be categorized. Tobacco use is the primary cause of such
illnesses worldwide. However, in a nation like India, where a large part of the population
works in factories and mines, the working environment and air pollution both play a
significant role in respiratory issues.

70% of deaths due to communicable diseases in India were caused by acute

respiratory infections. According to the National Health Profile, before the COVID-19
pandemic, 69.47% of deaths due to communicable diseases in India were attributed to
acute respiratory infections.

In my perspective, having health insurance covering lung-related diseases might be

lifesaving in a nation like India because of the given points:

 Chronic respiratory disorders might necessitate a lot of time and attention. They
require skilled care and medicines on a daily basis. As a result, many wind up
spending a significant portion of their resources on treatment.
  Hospitalization is prevalent among respiratory illness patients. The treatment costs
can be taxing on the households and cause distress.

 As a result of poor air quality, a substantial percentage of the population suffers

from TB, and the great majority of youngsters suffer from lung ailments. This places
a financial strain on low-income households in particular.

When it comes to considering lung-related diseases under social/private insurance, private

insurance prioritizes the contribution of the insured, while social insurance prioritizes
maximum coverage at the lowest possible cost. Common respiratory diseases must be
covered by public tax-funded social insurance in countries like India, where a large portion
of the population suffers from respiratory diseases such as asthma, tuberculosis,
pneumonia, and COPD and the majority of patients cannot afford private insurance. Such
initiatives would help this population to a very great length. Private insurance should seek to
cover rarer respiratory diseases such as lung cancer and pulmonary fibrosis.

Effects of health shocks on the design of health insurance:

Health shocks are defined as a decrease in a household's well-being caused by an accident

or illness sustained by one or more of its members. In a national setting, health shocks can
have a negative economic impact. During such times, the populace with reduced purchasing
power resorts to a variety of methods to cover their bills. These include selling real estate,
borrowing from money lenders, and so on. In times of disaster, having wide insurance
coverage not only helps families but also the nation recover. Policies must be designed to be
simple to execute and offer enough coverage at a low cost.

In situations like this, private insurance providers put their interests ahead and utilize the
crisis to foster gains from them at the expense of public health. Furthermore, the public
with limited financial means would be vulnerable to national-scale health shocks such as
Covid. It is critical for our health specialists to build a cost-effective model that not only
covers current health disorders but also analyses the impact health of shocks for dealing
with future health crises.

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