Mistakes are lessons of wisdom. The past cannot be changed. The future is yet in your power. Hugh White
More than a million Indians die each year due to lack of access to healthcare because over
700 million of us live in remote villages where basic healthcare facilities do not exist. Around
350 million of Indians live below the poverty line and survive on less than Rs 100/- per day,
which puts almost all medicines out of their reach.
It’s true that many government hospitals are supposed to provide medical care free of cost
to the underserved, but the poor do not even have the means to travel to the nearest Primary
Health Centre (PHC) to use these services. The numbers are mind-boggling, and the biggest
tragedy is that many of these deaths are preventable.
Unaffordable medical care
A large percentage of patients are unable to seek timely medical care because they cannot
afford it. In such cases, health insurance for the needy can ensure better access to healthcare.
Since most Indians are poor, it’s important that insurance companies float attractive,
affordable health insurance products.
These wheels have already been set into motion and health insurers now provide cover with
premiums as low as Re 1/- per day, which cater to the needs of the underserved in our
society. These can make a significant difference in making safe medical care more accessible
to the poor.
The first hurdle that has to be navigated is to create a demand for low-cost health insurance products because the target audience is still unaware of the benefits of these products. India has a very limited number of insurance companies and penetrating rural India is an uphill task for them.
They need to learn from leading FMCG and telecom companies that have managed to create a market where none existed before. The Insurance Regulatory and Development Authority (IRDA) (https://www.irda.gov.in/) has taken a lot of initiatives to help simplify health insurance. These protect the patient’s interests, by ensuring efficient and transparent claims settlements, and this will help to encourage more citizens to buy health insurance.
The role of the government
The government needs to build a robust national network so we can provide safe healthcare to Indians at affordable prices. The Rashtriya Swasthya Bima Yojana (RSBY, literally “National Health Insurance Programme”) is an innovative government-run health insurance scheme for the Indian poor.
It provides for cashless insurance for hospitalization in public as well as private hospitals, and has won plaudits from the World Bank, the UN and the ILO as one of the world’s best health insurance schemes. Under RSBY, smart cards are issued to BPL ( below poverty line) families; according to official figures, there were over 37 million active smart cards in June 2015.
Beneficiaries pay only Rs 30 as registration fee and the central and state governments pay the premium. RSBY, which was launched in 2008 was earlier with the Labor Ministry, and was shifted to the Health Ministry from April 1 2015, with plans to roll out a National Health Assurance Mission to provide universal healthcare. The Arogyasri scheme in Andhra Pradesh and the Yeshasvini programme in Karnataka are self-funded initiatives , which are run by the respective state governments.
Creating innovative products and business modelsHealth insurers need not limit themselves only to providing a financial safety net for patients – they can play a far more active role in developing the entire healthcare industry. Rural India is highly medically underserved right now, because patients don’t have the requisite paying capacity. However, if doctors know that patients living in small towns will be able to pay for their medical care because they are insured, they are very likely to settle down and start hospitals in these areas!
A health insurance cushion also allows individuals to seek care in better equipped hospitals that are likely to be safer, because they are accredited and have newer technology. These are more expensive, and would have been out of their reach had they not been insured, and were forced to foot the entire bill themselves.
Progressive insurers have also implemented safety measures such as a free mandatory second opinion whenever surgery is advised, to ensure that the care being advised is correct. They can also reduce over-testing and overtreatment by investing in patient education, thus helping to protect patients from unnecessary medical intervention