Updated on 27 November, 2019
A report by the National Statistical Office (NSO) stated that a majority of Indians don’t have health expenditure coverage.
Key-Highlights of the report:
The ministry conducted the survey on household social consumption related to health during July 2017-June 2018 as part of the 75th round of National Sample Survey (NSS).
Data for the survey was collected from 1,13,823 households (64,552 in rural areas and 49,271 in urban areas), covering 5,55,115 persons (3,25,883 in rural areas and 2,29,232 in urban areas).
- As per the report, 14% of the rural population and 19% of the urban population said they had health expenditure coverage.
- Over 13% of rural and 9% of urban population said they were covered by government-sponsored health insurance.
- A meagre 1% of rural population said they were covered by health insurance arranged by government/PSU as employer/ employer-supported health protection schemes.
- About 6% of urban population reported that they were covered by health insurance arranged by government/PSU as employer/ employer-supported health protection schemes.
- Showing an extremely low coverage of health insurance plans, about 4% of urban population said they were covered by health insurance arranged by households with insurance companies.
- Private sector was catering to a larger proportion of the population for medical treatment with the average medical expenditure per hospitalization case (excluding childbirth) in rural India about Rs. 16,676 and in urban India about Rs. 26,475.
- “In Government/public hospitals the expenditure was about Rs. 4,452 (about Rs. 4,290 in rural and Rs. 4,837 in urban areas).
- In private hospitals, the expenditure was about Rs. 31,845 (about Rs. 27,347 in rural and Rs. 38,822 in urban areas).
Health Insurance Sector:
- In India, the insurance industry consists of 57 insurance companies of which 24 are in the life insurance business, and 33 are non-life insurers.
- Among the life insurers, Life Insurance Corporation (LIC) is the sole public sector company. Apart from that, among the non-life insurers, there are six public sector insurers.
- Health Insurance Sector contributes around 23 percent of general insurance premiums and is one of the insurers' main drivers of growth.
- Gross premium increased from Rs 3.2 lakh crore (USD 49 billion) in 2011-12 to reach Rs 5 lakh crore ($72 billion) in 2017-18.
- Various study says that the Indian insurance industry is expected to grow to $280 billion by 2019-20 aided by the government's flagship Ayushman Bharat and increasing awareness about the need for protection.
Ayushman Bharat Scheme:
- This ambitious health insurance scheme aims to provide free health insurance of ₹5 lakh per family to nearly 40% of the population—more than 100 million poor and vulnerable families.
- The scheme is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service.
- It aims to undertake path-breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level.
- It is one significant step towards the achievement of Universal Health Coverage (UHC) and Sustainable Development Goal - 3 (SDG3).
- Launched on September 23rd, 2018, the scheme is targeted at poor, deprived rural families and identified the occupational category of urban workers’ families.
- It promises health coverage of Rs 5 lakh per family to over ten crore low-income families.
- The premium payment expenditure is shared by the central and state governments.
Universal Health Coverage:
Despite a decade-long work under the National Rural Health Mission, a vast majority of Indians remains out of the health care for all umbrella.
- Universal coverage refers to a scenario where everyone is covered for, at least, basic healthcare services.
- Universal health coverage (UHC) includes the following components:
- To ensure health services for all Indian citizens in any part of the country, regardless of income level, social status, gender, caste or religion.
- Health services must be affordable, accountable and of high quality.
- UHC should be promotive, preventive, curative and rehabilitative.
- Services should address the wider determinants of health delivered to individuals and populations.
- The government must be the guarantor and enabler, although not necessarily the only provider of health and related services.
- UHC must meet the objectives of improving coverage, expanding access, controlling cost, raising quality, and strengthening accountability.