Only 27% Indians are covered by health insurance

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Urgent need to widen access to quality healthcare and insurance

New Delhi, 19 December 2017: As per a recent report, only 27% of Indians have health insurance coverage. The Indian healthcare sector is largely under penetrated with government expenditure constituting approximately 1.4% of the country’s GDP. The private sector expenditure constitutes 70% of the total healthcare expenditure. Of this, about 62% is out of pocket and only 8% is covered through pre-financed instruments.

There is a significant gap in the coverage offered by current products and the need for a comprehensive ecosystem of financed healthcare. Healthcare costs are increasing by the day primarily due to lifestyle diseases. The only way to bridge the gap between rising healthcare costs and affordability is through developing a sustainable and viable mechanism in the insurance sector.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Health insurance is essential not just for the physical health of a family but also for their financial well-being. It enables access to appropriate health care while reducing the impact of an untoward health event on a family’s earning and payment capacity. Out-of-pocket expenses today account for nearly twice as much as institutional expenses. Thus, there is a need for an all-inclusive solution towards healthcare in the Indian market. The need of the hour is a centralized health savings scheme managed by a government-nominated body or privately managed by insurers with centralized fund management. This will ensure availability of funds for accessing healthcare services to more people, which will further go a long way in realizing the goal of providing healthcare to all.”

As per the Indian constitution, Article 14 and 21, health is the fundamental right of every Indian citizen. Under the Directive Principles of State Policy, the state governments are entrusted with the responsibility of ensuring good health of their people. It is the state government’s responsibility to look after emergencies and primordial prevention.

Adding further, Dr Aggarwal, said, “Quality always comes at a price. Quality treatment is costlier but in the long-term, it is economical as it is associated with fewer hospital-acquired infections, complications, adverse drug reactions, re-hospitalization, as well as fewer system failures. Quality is always preferred but it may not always be feasible because quality care may increase the cost of treatment. This necessitates the need for insurance.”

Every hospital or health care establishment must try to improve and maximize quality within the resources that are available to them and with the best use of those resources. Poor quality service indicates poor utilization of resources. Both quality and affordability need to be balanced, especially in a country like ours, which has one of the highest out of expenditures on health in the world.