Insuring a Billion Lives by Improving Awareness, Assurance, Availability and Affordability

New Delhi: India’s healthcare has evolved since the time of independence and is currently at a very critical juncture. The current health insurance coverage stands at mere 35% in the country. The epidemiological shift in diseases burden towards non-communicable diseases and rising healthcare inflation in the country further accentuates the need to provide financial cover to the mass population. There have been strides taken to address the idea of affordable and quality healthcare through various flagship programmes such as PMJAY – Ayushman Bharat, however, creating awareness, accessibility, affordability and assurance to drive health insurance penetration is imperative.

Towards insuring a billion Indians, CII has organized the 15th Health Insurance Summit – “Health Insurance 2025 – Covering a Billion Indians”. Addressing the inaugural session at the CII Health Insurance Summit, Dr RS Sharma, Chief Executive Officer, National Health Authority stated that “on the Ayushman Bharat Front, we have been working on four areas; to create awareness among the beneficiaries, to ensure that the rates provided to the private sector are consistent with market rates, to ensure the payment to the hospitals is done in a time bound manner, and to ensure a quick turnaround time.” He further added that we should as a country proceed towards UHC. We should proceed towards ensuring every eligible Indian either through public, private or co-payments. Co-payments can be used to support the missing middle segment of the population.

CII launched the report titled “Health Insurance Vision 2025 –Insuring Lives of Billion Indians” at CII’s 15th Health Insurance Summit. The CII-BCG report highlights the key challenges that the sector faces: low health insurance awareness, gaps in product understanding and value proposition and limited last mile insurance distribution channels. In order to overcome these challenges, the report recommends driving ‘awareness’ via industry-wide efforts, curating product offerings to the needs of segments to create ‘assurance’, making insurance ‘affordable’ through cost, pricing measures and strengthening distribution to the last mile to improve insurance ‘access’. It presents actions to simplify insurance for better understanding, eliminate operational inefficiencies, foster innovation in product and delivery models while strengthening healthcare infrastructure and governance mechanisms for improved quality of care.

Addressing the need for greater health insurance coverage, Mr Saurabh Mishra, Joint Secretary, Department of Financial Services, Ministry of Finance stated that “India’s out of pocket expenditure is one of the highest in the world, and therefore insurance is a mandatory ask that will help minimize out of pocket expenditure.” He further added that the missing middle is the area we are seeking out solutions that are cost and delivery efficient and is visible enough to people who are missing out on insurance.

Mr Suresh Mathur Executive Director, Insurance Regulatory and Development Authority of India (IRDAI) highlighted that low health insurance penetration in the pandemic will lead a large percentage of people falling into poverty. People are uninsured due to lack of awareness of insurance as a protection tool and the types of insurance that exists. Creating awareness should be an important moto for all the stakeholders as insurance awareness plays a key role in the development of the insurance sector.

Significant portion of India still remains un-insured, and this a cause of worry, as covid has shown the devastating effect of people who lack health insurance. Therefore, we need to expand the coverage to this missing middle. The NHA is going to expand the pilot of National digital health mission beyond the six Union Territories and throughout India. We need to make insurance more accessible and affordable addressed Dr Praveen Geedam, Additional Chief Executive Officer, National Health Authority (NHA).

Ayushman Bharat was undertaken for the following reasons: due to lack of affordability and low purchasing power of citizens, NCD disease burden has increased by 25%, high out of pocket expenditure, and no portability of state schemes expressed Dr Vipul Aggarwal, Deputy Chief Executive Officer, National Health Authority (NHA). The current distribution model or the last mile connectivity is not working. The digital medium has to be addressed, before that the industry needs to fix the issue of having a product the customers are willing to pay for stated Ms Malti Jasiwal, Senior Consultant, World Bank & Advisor, National Health Authority.

Speaking on initiatives to further protect Indian citizens, Dr Naresh Trehan, Chairman, CII Council on Healthcare & Chairman and Managing Director, Medanta – The Medicity stated that we need to create a health saving account in India which will help people put aside money on a regular basis. This alongside health insurance will help create an adequate safety net.

Mr Tapan Singhel, Chairman, CII National Committee on Insurance and Pensions and Managing Director & CEO, Bajaj Allianz General Insurance Company highlighted that if we are able to cover a billion lives, we are talking about increasing the average life span of Indians by about 5-7 years.

Mr. Krishnan Ramachandran, Chairman, CII Task Force on Health Insurance & Chief Executive Officer and Managing Director, Max Bupa Health Insurance Pvt Ltd expressed that India is one of the few countries where covid is covered by insurance. COVID has impressed on us the urgent need to get all Indians financially protected and the need to invest in healthcare as comparable to developing nations who’s spend is closer to 7% of GDP.

Focusing on accelerating and building upon the National Health Stack, sustaining the interest to invest in Healthcare Infrastructure in Tier2/Tier 3 and remote parts of India and anchoring care financing solutions closer to the consumer needs would be game changers in improved adoption and uptake of Health Insurance for a billion Indians – highlighted Mr Pranay Mehrotra, Partner and Managing Director, BCG.

CII Health Insurance Summit provides the necessary platform for stakeholders across the world to converge and embed their ideas to help usher in a new era of Health Insurance. This platform seeks to address a wide range of issues that cuts across the health-insurance spectrum looking to develop a cohesive industry engagement with core cross sectoral policy dialogues and strategic exchanges. CII is committed to the vision of achieving Universal Health Coverage in India.