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Converging Towards a One Country One Scheme to Achieve Universal Healthcare
Oct 15, 2020

India’s healthcare has evolved since the time of independence and is currently at a very critical juncture. Steps have been taken to address the idea of affordable and quality healthcare through various flagship programmes such as PMJAY -  Ayushman Bharat, however, areas such as accessibility, absence of human power, accountability and the lack of awareness among the general population continues to hinder the progress of the overall ecosystem.

India is faced with twin challenges of high prevalence of communicable diseases and risk of premature deaths from non-communicable diseases (NCDs). The overall healthcare spend in India is 4.2% of GDP (2018), lowest amongst BRICS counties, while global health care expenditure average amounts to approximately 10.2%. This is further exacerbated as the Government healthcare expenditure has largely been stagnant during last 10 years (~1.2% of GDP in 2018). This has resulted into high out of pocket (OOP) spend on healthcare (65%). There is an urgent need to make quality healthcare accessible to all Indians along with sustainability for healthcare providers

At the 14th Health Insurance Summit 2020 organized by Confederation of Indian Industry (CII) saw the presence of senior policy makers, regulators along with Industry Leaders from the Healthcare Sector addressing important issues including role of technology in improving Health Insurance covers, Making Health for All a reality, and Legal Fraud Management within Health Insurance.

CII launched the Working report titled “Driving Health Insurance Penetration in India – Covering the Missing Middle”. This attached report recommends a dual approach to scale the health infrastructure focusing on public health and simultaneously focusing on achieving universalized health insurance.

Dr Subhash C Khuntia, Chairman, Insurance Regulatory and Development Authority of India (IRDAI) addressing the inaugural session at the 14th Health Insurance Summit stated that Health, Education and Nutrition is absolutely essential to develop the human resources in every country. Only if people are health and education, they would be able to contribute to the social and economic development of the country. Health insurance is playing its part in maintaining this ecosystem. As the cost of treatment is increasing at the rate of 14%, it is imperative that all the stakeholders in the system work towards lowering costs.

More than 20% of the population still live under 1.9$ per day, this coupled with large portion of the citizens faced with the triple burden of diseases, lack of access to affordable healthcare and exorbitant out of pocket expenditure has exacerbated the need for Ayushman Bharat stated Dr Vipul Aggarwal, Deputy CEO, NHA. 53.7 crore people can avail the benefits of PMJAY and we are now moving towards the convergence of health insurance schemes and come to a 1 country, 1 scheme concept.

Ms Malti Jaiswal, Advisor, NHA stated that there is a change in pattern in the utilization of care. Our attention should be shifted towards the standardization of care, while looking at the overall outcomes. We have to ensure primary care is very robust, be it primary health care centers or clinics that are providing services to the public at large expressed Mr DVS Ramesh, General Manager (Health), Insurance Regulatory and Development Authority of India (IRDAI).The focus now should be on ensuring primary care to all sections of the population.

Traditionally, diseases constitute of four parts; health of the population, prevention of disease, early detection and treatment expressed Dr Naresh Trehan, Chairman, CII National Council on Healthcare & Chairman and Managing Director, Medanta - The Medicity. It is imperative we provide care at every level at a price point which becomes comparatively low and provide end to end care at the best price.

All Indians need to be brought under the coverage of health insurance. For this , there are three important themes that needs to be addressed; Awareness, Trust and Affordability stated Mr Krishnan Ramachandran, Chairman, CII Taskforce on Health Insurance & Chief Executive Officer and Managing Director, Max Bupa . This will allow us to take penetration to a point where access to quality healthcare is affordable to every Indian.

For us to be able to deliver affordable healthcare over their life time, players and providers need to work on a long term sustainable basis, in terms of quality and access stated Mr Sanjay Datta, Co Chairman, CII Taskforce on Health Insurance & Chief - Claims, Underwriting and Reinsurance ICICI Lombard General Insurance

15 October 2020 

New Delhi 

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