Three years ago, I wrote an essay titled “Universal Health Insurance –Will this meet the expectations of affordable care to all citizens?”. For this essay, I was the winner of the essay competition from Insurance Institute of India. Here is the abstract of my essay.


Universal Health Coverage has a direct impact on the productivity of the citizens as better health care leads to better lives and less financial loss. Globally, at least a billion people suffer each year because they cannot obtain the health services they need.In India, health insurance is fragmented as there are certain central health sector schemes such as Rashtriya Swastha Bima Yojana and the recently launched Pradhan Mantri Jeevan Jyoti Bima Yojana, as well as state health sector schemes too which overlap in many ways.Universal Health Insurance in itself will not be able to provide affordable care and reduce poverty and have better health care to Indians. A holistic approach should be followed to address affordable health care. Investment in large scale infrastructure, namely, water and sanitation facilities, health centers, providing affordable medication and treatment facilities, etc. are highly capital intensive programs, and take several years to implement. Similarly, setting up of hospitals, training of the medical students and nurses involve several years of investment in time, money and other resources.

These challenges will require a Top Down approach, where a large Government scheme is run or managed by private players. However, the insurance industry can play an active role by adopting innovative ideas such as providing insurance coverage for traditional medicine, encouraging use of generic drugs against prescription medicines, and focus on preventative health in addition to providing treatment options. Other ways include forward looking measures such as products that focus on lifestyle diseases, working with the insurance regulator and policymakers to set up more insurance companies that have a regional focus. Issues such as rapid urbanization and climate change are challenges of tomorrow that will bring their own set of healthcare issues, the industry needs to invest in research on such matters. For example, outbreaks of bird flu and swine flu have become more widespread in recent years. The insurance industry needs to be at the leading edge of the challenges of tomorrow.

The other challenge is that the majority of affordable healthcare programs focus on inpatient treatment, while the outpatient treatment, which can often be the larger cost component, is largely ignored. Similarly, as the per capita income of India will increase, so will the pattern of health challenges, where one may start witnessing more ailments and deaths due to lifestyle, occupational and other factors. At the same time, the population of the country is expected to keep growing for the next several diseases. This will add to the complexity of challenges for the insurance sector. The mobile phone could be the primary tool of information for preventative health, as well as monitoring the health parameters that can help in early detection and prevention of ailments. The insurance industry can partner with incubators so that startups will bring innovations. In an era of ever- rising healthcare costs, affordability need not be only viewed as “what is affordable to the recipient”, but also as “what is affordable for the economy and the insurance industry.”

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