CII has mooted setting up of a National Health Regulator under the Ministry of Health and Clinical Establishment Act to speed up Universal Health Coverage (UHC). Equally important is setting up of the Universal Health Care Agency to coordinate with all the relevant ministries, departments, health and insurance regulators etc.
This suggestion is contained in the Report of CII Working Groups on Health Insurance, a document prepared after considerable dialogue among the stakeholders, which was released today at the CII Health Insurance Summit. The core group of CII constituted by CII for the preparation of the Report included major stakeholders in the healthcare and insurance verticals like Johnson and Johnson, ICICI Lombard, IRDA, KPMG Advisory Services; Global Hospitals Group; Oriental Insurance; New India Assurance; Apollo Munich; Future Generali and IFFCO-TOKIO.
The CII report underscores a hybrid model for a sustainable UHC, which presupposes the role of government and the insurance companies as key players to roll out the scheme. People above the poverty line, who have willingness and ability to pay should contribute/pay for the secondary and tertiary coverage. However, the premium should be affordable. However, the basic (primary) cover should be mandatory and made available to all citizens, which should be linked to issues like safe drinking water, sanitation, and nutrition.
The UHC scheme should mandatorily consist of primary health cover, as secondary cover and a critical care and defines various parameters of eeach segment.
According to the CII Report, the roadmap to UHC implementation is not without challenges – legislative, operational, IT architecture, monitoring mechanism etc. However, clear cut planning has to be done to overcome these issues through healthy dialogue among the stakeholders. The roll out of UHC in a unique Indian model of low cost has many economic benefits. The enormous cost of double burden of disease and dampening impact of an unhealthy population on economic growth is too high to be ignored.
Though health is not a fundamental right in India, the model proposes to provide universal access to it in a gradual manner starting with the poor and vulnerable segments. Access to curative care, both secondary and tertiary would be through insurance mechanism, using empanelled public and private healthcare providers.The paper also suggests strategies, ways and means to enroll people on voluntary basis till the time legislative backing is implemented.