Insurance Delays and Access to Bariatric Surgery

Why in News?

Recently, a survey conducted by the Obesity and Metabolic Surgery Society of India (OSSI, has revealed significant insurance-related hurdles that are preventing timely and life-saving care for patients living with severe obesity.

What is the study?

• Conducted by – Obesity and Metabolic Surgery Society of India (OSSI).
• OSSI – It is a not-for-profit body of bariatric and metabolic surgeons
• OSSI survey highlights approval delays, IRDAI coverage gaps and bariatric surgery insurance hurdles.
• Title – The study titled ‘The Surgeons’ Perspective on Insurance Coverage for Metabolic and Bariatric Surgery for India’ is published in Obesity Surgery: The Journal of Metabolic Surgery and Allied Care.
• IRDAI mandate – The Insurance Regulatory and Development Authority of India (IRDAI) mandated coverage for metabolic and bariatric surgery in 2019 when medical criteria are met.
• The OSSI survey, conducted among 109 bariatric surgeons across multiple states between November 2024 and March 2025, paints a stark picture.

What are the Survey findings?

• Criticality of obesity – Doctors stress that obesity is not a lifestyle flaw, but a chronic, progressive condition linked to type 2 diabetes, hypertension, sleep apnoea, heart disease, infertility, and certain cancers.
• Bariatric and metabolic surgery – It can reduce body weight by 30 to 40% and reverse many associated illnesses, is among the most effective treatments.
• Yet, limited insurance support leaves many patients untreated or waiting for months.
• Delayed insurance approval – 95.4% of surgeons reported patients delaying surgery while awaiting insurance approval.
• Lack of awareness – Most surgeons (76.1%) said patients are unaware that insurance covers bariatric surgery even when medical criteria are met.
• Complex approval process – The approval process was rated complex by 69.7%, and 91.7% said it is more cumbersome than other routine surgeries.
• Large denial rate – Nearly one-third reported denial rates of 50 to 75%, citing obesity exclusions, waiting periods, and documentation discrepancies.
• Increasing expenditure of people – 81.7% noted significant out-of-pocket costs despite insurance.
• Implementation barriers – The survey shows implementation remains inconsistent, creating barriers that delay treatment, worsen complications, and increase long-term healthcare costs.
• Rising obesity burden – India’s obesity prevalence is projected to triple by 2040.  

What are the measures suggested?

• Lowering BMI threshold – Surgeons strongly supported lowering BMI thresholds and covering more comorbidities than currently listed under IRDAI rules.
  • OSSI guidelines recommend surgery for patients with BMI ≥35 kg/m² or >30 kg/m² with comorbidities.
  • IRDAI restricts coverage to BMI ≥40 kg/m² or ≥35 kg/m² only with severe comorbidities.
• Improving accessibility – Insurance providers should understand that obesity is a medical disease and that treatment should be easily accessible.
• Process simplification – Simplifying the process and widening eligibility criteria will help thousands of individuals who are fighting serious weight-related illnesses.
• Other measures – Insurers should act with clarity and compassion,
  • Including obesity-related conditions like type 2 diabetes,
  • Reducing unnecessary documentation can make a huge difference.

What lies ahead?

• Bariatric and metabolic surgery is not cosmetic, it is a scientifically proven, disease-modifying treatment that prevents long-term complications.
• Insurance coverage is not a privilege, it is a medical necessity that saves lives.
• Addressing these gaps through simpler approvals, wider eligibility, and stronger awareness can improve access to life-saving treatment and strengthen India’s public health landscape.
• Early access to bariatric and metabolic surgery not only improves patient health but also reduces long-term healthcare costs for families and insurers.

Reference

The Hindu| Insurance Delays and Access to Bariatric Surgery

Presidential Reference V/S The Federal Structure

Why in News?

Recently, the Supreme Court of India’s answers to the 16th Presidential reference on the powers of Governors and the President of India has risen many questions.

What are the terms to be understood?

• Presidential reference – It is a constitutional mechanism in India, under Article 143, where the President of India seeks an advisory opinion from the Supreme Court on a question of law or fact of public importance.
• Federal structure - A federal structure is a system of government where power is divided between a central authority and regional governments (like states or provinces).
• Status of states in India
  • Equal partners – Under the constitutional scheme, the Union and States are equal partners, with the Government of India being only ‘first among equals’.
  • Units of autonomy – States are not subservient to the Union Government, nor are they secondary appendages, bound by the diktats of the Government of India.
  • In fact, in all areas in the State list (such as land laws and law and order), they enjoy complete autonomy.

What are the issues with the governor?

• Delay in assent to bills – Delaying the bills passed by the state legislature idefinitely by the Governor would effectively mow down an ‘elected Legislature’ before the whims of an ‘unelected Governor’.
• Acting as agents of ruling party – Governors are appointees of the ruling party at the Centre, who, more often than not, act on the whims of those in power in the Government of India and even actively accommodate their political agendas.
• The scales of federalism and democracy must be weighed between what the Supreme Court calls the “unwritten and undefined powers” of an unelected Governor.
• Serving the political agenda – Governors act to serve the political agenda of the Government of India vis-à-vis the mandate of an elected State Government and Assembly reflecting the will of the people of that State.
• Absence of timeline – Once the Legislature has passed a law, a timeline on the exercise of the powers by the Governor, under Article 200 of the Constitution of India, has to be read therein to bring it in conformity with the principle of federalism, which is part of the basic structure.
• This is not just harmonious but also imperative in the current climate of unprecedented administrative excesses.
• Past judgement of Supreme Court – The two-judge Bench in the Tamil Nadu Governor’s case understood this and prescribed finite and reasonable timelines accordingly.
• This decision of the court which led the President to seek an opinion from the Supreme Court.

What are the benchmark to measure the legitimacy of governor's power?

• Power of the Governor – It has to be tested on the touchstone of reasonableness, i.e., a reasonable time to think through and decide on the Legislation.
• If this timeline is not read, the Governor will become an unelected despot over an elected Government.
• Essence of constitution – Fairness, reasonableness and non-arbitrariness are the threads that run through the veins of our Constitution, and especially Part III which protects citizens against a wayward state.
• If you anoint unelected Governors or even the President of India as unbridled monarchs over elected governments, the entire edifice of the Constitution will start to crumble.
• Judicial Review – It is also a part of the basic structure of the Constitution. No authority, howsoever high it may be, including Parliament, can ever say that its actions will not be tested by judicial review.
  • The exercise of powers by the Governor or the President of India cannot remain alien to the principle of judicial review.
  • The office of Governor or the President of India is not bigger than Parliament.
  • Even Parliament cannot escape judicial review for its actions.
• Against constitution – The theory of ‘limited direction’ propounded by the Court goes against:
  • The grain of the constitutional scheme,
  • The doctrine of federalism,
  • The doctrine of reasonableness enshrined in Article 14,
  • The doctrine of judicial review and the principles of fairness and justice.
• Unrestrained powers – To give such unbridled power to the Governor and the President to keep important pieces of legislation pending for long periods of time, so as to defeat the very purpose thereof, cannot be accepted.

How the federal design is undermined in recent times?

• GST compensation disputes – The refusal by the central government to provide compensation to producing States for loss of Goods and Services Tax, thereby effectively disincentivising efficiencies, revenue generation and good governance.
• Issues with cess – The cess collected exclusively by the central government being used as an excuse to deny sharing of its revenue with the States.
• Denial of devolutions – Refusal by the central government to fully implement the devolutions recommended by the Finance Commission.
• Placing financial pressure on states – forcing States to adhere to a ‘one-size-fits-all’ conditions to central schemes and making them conditionally applicable to States only on States agreeing to contribute up to 50% of the schemes budgeted expenditure.
• Misapplication of Financial powers – Weaponisation of money in the central kitty by providing financial support as a quid pro quo for advancing the political agenda of the party at the Centre.
  • For Instance, the recent transfer of ₹10,000 to 1.21 crore women in Bihar very close to the Bihar Assembly election 2025 or the grant of a special financial package for Andhra Pradesh in the last Budget are two recent examples.
• Misuse of institutions – The misuse of the Central Bureau of Investigation/Enforcement Directorate/Income-Tax Department to raid, browbeat, arrest Chief Ministers and Ministers and bring down Opposition governments.
• Control through governor –The central control through the Governor’s fiat, which will collapse the spirit of federalism.

What lies ahead?

• If this deep distortion of federalism is permitted to take root, the Union Government will command unrestrained authority while States are reduced to mere administrative outposts.
• Democracy cannot survive where the will of the people is held hostage to the whims of unelected constitutional functionaries.
• It is imperative that citizens take notice, institutions reflect, and the Supreme Court reconsiders.
• Because the preservation of federalism is the preservation of India itself.
• In the journey of every nation, there comes a moment where institutions must stand up as solid guardrails to defend what is intrinsic to the foundational values of the nation-state.
• Because, if the foundational principles are allowed to crumble, the remaining structure will wither away.
• Further, the institutions which sanction such an obliteration of core ideas, almost always meet the same end.
• Once the tree falls, the branches cannot survive.

Reference

The Hindu| Presidential Reference vs Federal Structure

National Mission for Mentoring (NMM)

Why in news?

The University Grants Commission (UGC) has called on all higher educational institutions (HEIs) across India recently to nominate teaching faculty under the National Mission for Mentoring (NMM).

• Launched in – 2022, in 30 selected Central Schools (including permanent, contractual and para-teachers such as Shiksha Mitra and Niyojit Shikshak).
• Aim – To establish a robust national network of mentors to enhance teacher professional development at all levels of education.
• Nodal Ministry - Ministry of Education.
• Implementing Body - AICTE (All India Council for Technical Education).
• Instituted Under – The umbrella of the National Education Policy 2020 (NEP 2020).
• Objective - To provide emotional, academic, and professional mentoring to students through trained mentors, ensuring guidance on:
  • Career planning
  • Academic improvement
  • Mental well-being
  • Internship and skill development
  • Entrepreneurship and innovation
• Key Features
• Mentoring Portal
  • A nationwide digital platform to connect mentors and mentees.
  • Students can register and choose mentors based on interest and career paths.
• Types of Mentors
  • Academicians
  • Industry professionals
  • Retired professionals
  • Entrepreneurs and innovators
• Coverage
  • School students (especially from Classes 9–12 in some programmes)
  • Undergraduate and postgraduate students
  • Aspiring entrepreneurs
• Mode of Mentoring
  • One-to-one mentoring
  • Group mentoring
  • Virtual interactions
  • Structured sessions and webinars
• Volunteer-driven Programme
  • Mentors participate voluntarily as part of national service.
• Structure - The "Bluebook" - NCTE has published a guide titled "NMM - The Bluebook", which serves as a roadmap, outlining the architectural framework, objectives, strategies, and practical guidelines for all stakeholders.
• Stakeholders – Mentor (the guide); Mentee (the teacher); and Nodal officers/administration.
• Implementation strategy –
  • Pilot phase – Tested in 30 Central Schools (15 Kendriya Vidyalayas, 10 Jawahar Navodaya schools, and 5 CBSE schools) with 60 mentors, some even Padma Awardees.
  • Building capacity – Seminars and workshops are conducted to teach “Master Mentors” who can subsequently teach others.
  • Incentivisation – Although participation is voluntary, it encourages participants to do so with certificates, performance credits and other incentives.
• Outcome – Reduce isolation/burnout, improve work-life balance, foster Community of Practice.

References

The Hindu | National Mission for Mentoring

Pallid Harrier

Why in News?

The Pallid Harrier, a bird that migrates from Central Asia, has reached its roosting ground in Tirunelveli, Tamil Nadu.

• Scientific name – Circus macrourus
• Habitat – It prefers open habitats such as natural grasslands, dry steppes, bogs, and agricultural areas.
  • In India, it prefers grasslands and thin scrub in semi-arid and arid regions and is also found in the high elevation shola grasslands of the Western Ghats.
• Distribution – It breeds in southern Europe, Central Asia, and Iran, and winters mainly in Africa, India, and Southeast Asia.
• Appearance –
  • Size – A medium-sized raptor, measuring 40–48 cm in length with a wingspan of 95–120 cm and weights around 235–550 g.
  • It exhibits sexual dimorphism, meaning males and females have distinct plumages.
  • Males – Pale or "ghostly" grey above and white below, with narrow black wedges at the wingtips.
  • Females – Brown above with white upper tail coverts (earning them the nickname "ringtails") and buff underparts streaked with brown. They have a well-defined facial pattern.
  • Juveniles – Rufous (reddish-brown) and have a distinct whitish collar or "boa" around the neck.

• Prey – It feeds on rodents, such as mice, voles, lemmings, ground squirrels, small terrestrial birds, also consume lizards, other small reptiles, frogs, and insects, such as locusts and dragonflies.
• Conservation Statius –
  • IUCN – Near Threatened
  • Wild Life Protection Act, 1972 – Schedule IV
• Threats – Habitat destruction due to burning (natural and man-caused), conversion into farming lands, or over grazing.

Quick Fact

References

1. The Hindu | Pallid Harrier
2. Peregrine fund | Pallid Harrier

Indo-Tibetan Border Police (ITBP)

Why in News?

The Director General said recently at the ITBP’s 64^th Raising Day Parade in Udhampur that ITBP is set to establish all-woman forward posts at 10 locations along the 3,488 km India-China border.

• It is a Central Armed Police Force (CAPF) under the Ministry of Home Affairs (MHA).
• Nickname – It is known as the “Himveers” (brave soldiers of the Himalayas).
• Formation – It was raised on October 24, 1962, in the aftermath of the Sino-Indian War, to guard the Himalayan borders.
• Formed under – ITBP was initially raised under the CRPF Act, however, in 1992, parliament enacted the ITBPF Act, and the rules thereunder were framed in 1994.
• Primary role – At present, the ITBP guards a 3,488 km-long India-China border ranging from the Karakoram Pass in Ladakh to Jachep La in Arunachal Pradesh.
• Motto – “Shaurya – Dridhata - Karma Nishtha” (Valour – Determination – Devotion to Duty).
• Functions – Border Security – Vigil on the northern borders, detection and prevention of border violations, and promotion of the sense of security among the local populace.
• Internal Security – Deployed for counter-insurgency and election duties, checks illegal immigration, trans-border smuggling, and crimes.
• Disaster Response – Specialized in mountaineering, rescue, and relief during earthquakes, floods, and avalanches.
• Security – Protects sensitive installations, banks, and protected persons.
• UN peacekeeping operations – The Force is deployed for peacekeeping operations in Angola, Namibia, Cambodia, Bosnia Herzegovina, Mozambique, and Kosovo.
• Strategic Importance – ITBP is often called the “Sentinels of the Himalayas” because of its deployment in extreme terrain and weather.
• Plays a crucial role in India-China border standoffs (e.g., Doklam, Galwan).
• Works in coordination with the Army but remains under civilian control (MHA).

References

Indian Express | ITBP to establish 10 all-woman forward posts

Tex-RAMPS Scheme

Why in News?

The Union Government has approved the Textiles Focused Research, Assessment, Monitoring, Planning, and Start-up (Tex-RAMPS) Scheme, to strengthen India’s textiles sector.

• Aim – To strengthen India’s textiles and apparel (T&A) ecosystem, it is designed to address critical gaps in research, data systems, innovation support, and capacity development.
• Implemented as – A Central Sector Scheme, for FY 2025-26 to FY 2030-31, co-terminus with the upcoming Finance Commission cycle.
• Nodal Ministry – Ministry of Textiles.
• Focus – Advanced research in areas like smart textiles, sustainability, and new technologies.
• 5 pillars of Tex-RAMPS –
  • Research & Innovation – Promote work in smart textiles, sustainability, and efficiency-driven production systems.
  • Data, Analytics & Diagnostics – Include the India Size study, employment mapping and supply chain analytics to support stronger policy frameworks.
  • Integrated Textiles Statistical System (ITSS) – Offer real time data and monitoring capabilities for informed decision making.
  • Capacity Development & Knowledge Ecosystem – It will strengthen state level planning, training and knowledge sharing.
  • Start-up & Innovation Support – Support for incubators, hackathons and academia industry collaboration to accelerate textile entrepreneurship.
• Expected Outcomes –
  • Enhance India’s competitiveness in global markets
  • Strengthen research and innovation ecosystems
  • Improve data-driven policymaking
  • Generate employment opportunities
  • Foster deeper collaboration between States, industry, academia, and government institutions.

References

PIB | Government Approves Tex-RAMPS’ Scheme

Booth Level Officers (BLOs)

Why in News?

Concerns have been raised that several BLO deaths have been reported from the states undergoing Special Intensive Revision (SIR) of electoral rolls.

• Definition – A BLO is a government or semi-government official appointed by the Election Commission of India (ECI) to act as the custodian of the electoral roll at the polling booth level.
• Primary Role – They serve as the link between voters and the election machinery, ensuring that the electoral roll is accurate and updated.
• Appointment – BLOs are usually drawn from local institutions such as schools, government offices, or other public sector organizations.
• Teachers, Anganwadi workers, Panchayat Secretary, Village Level Workers, Electricity Bill Readers, etc, are mainly appointed as BLOs.
• BLOs are not full-time electoral officials.
• Section 13B of the Representation of the People Act, 1950 paved the way for the introduction of appointing a BLO for the 1^st time in August 2006.
• Coordination - Works under
  • Electoral Registration Officer (ERO)
  • Assistant Electoral Registration Officer (AERO)
  • Coordinates with Booth Level Agents (BLAs) of political parties
• Roles and duties of BLOs
• Electoral Roll Management – They verify voter details at the booth level and distribute and collect forms for voter registration, corrections, and deletions.
  • Conduct door-to-door verification to prevent duplication or bogus entries.
• Voter Facilitation – They help citizens understand the registration process, provide information about polling stations, and voting procedures.
  • Assist vulnerable groups (elderly, differently-abled) in accessing electoral services.
• Informing eligible voters for Postal Ballot – Senior citizens above 85 years & PwDs with benchmark certificate - about availing Home Voting Facility and Postal Ballot Facility.
• Election Duties – They ensure smooth conduct of elections at the booth and act as the point of contact for voters regarding electoral queries and report irregularities or issues to higher election authorities.
• Promote use of EC’s IT applications – Responsible for promoting the applications launched by ECI to facilitate voting and ensure an accurate electoral roll.
  • Popular voter-oriented apps like Voter Helpline App, eVIGIL app, Know Your Candidate app, and Saksham-ECI.

Reference

Indian Express | Booth Level Officers (BLO)