India’s health system finds itself at a watershed moment and while a lot of different kinds of medical technologies and infrastructure have improved significantly, many in India continue to have difficulty
Accessing affordable, high-quality healthcare. The nation is in the inadequate position of having two threats to health (communicable and non-communicable diseases), as well as issues associated with inefficiencies in the system, and these have reinforced the need for meaningful health policy in India and some major changes in the legal and regulatory structures framing the Indian health ‘plan’ or health insurance.
From crowded public hospitals to limited access to costly private care, there are a wide number of issues that comprise the Indian healthcare system. Programs like Ayushman Bharat have made some important strides, but there are still issues related to implementation of the programs, system gaps, and coverage. In this blog, we will elaborate on some of the pressing challenges, elaborate upon the role of policy and insurance in the healthcare system, and provide some solutions to public health in India.
The Current Landscape: Challenges in India’s Healthcare System
1. Inadequate Public Health Infrastructure
India’s public health infrastructure is difficult to navigate and becomes over whelmed quickly, especially in rural areas. Due to over crowded hospitals, a lack of available beds and equipment that feels outdated, effective delivery of services is limited to funnelling resources to the chronically sick and comorbid patient.
2. Human Resource Shortages
A real shortage of healthcare professional human resources leads to a dramatic shortage of doctors and nurses, and other technicians that create an even greater shortage of services. This is exacerbated by a shortage of healthcare practitioners, particularly in rural areas.
3. Low Health Expenditure
India spends about 1.2%-1.5% on public health (GDP), which is low relative to global statistics/benchmarks, and not enough to grow or develop systemic healthcare services to support growing demands.
4. Changing Disease Burden
The increasing burden of non-communicable diseases (NCDs) like diabetes, hypertension, and cardiovascular diseases leads to increased out-of-pocket costs for patients. A recent study organized in Punjab indicated many households have experienced catastrophic health expenditures, even without health coverage, due to the rising burden of NCDs.
The Medical Insurance Conundrum
1. Tax-Saving Perspective Rather Than Risk Protection
In India, health insurance is seen more as a tax-saving/expenditure item than a financial protection mechanism against medical emergencies, and this perception reframes the essence of insurance.
2. Opaqueness of policies and claim denial
Many insurance policies have ambiguous terms of policy that are unclear or exclusions that are deliberately obtuse. The length of waiting periods often add to the number of denials, leaving the insured completely vulnerable at critical times.
3. Limited coverage and a high share of out-of-pocket Expenditures
In spite of schemes like Ayushman Bharat, there are large sections of the population that are not insured or currently under-insured. Out-of-pocket expenditures account for a disproportionately high share of healthcare financing in India.
Strategic Reforms for a Healthier Nation
1. Address Public Healthcare System
A significant aspect of expanding the healthcare system is investing in public health infrastructure (more hospitals, new and upgraded equipment and materials for treating patients).
2. Improve Workforce
Human resources can be improved through education and training, and fill gaps in the workforce. Education incentivizing practitioners to work where services are needed most in rural settings.
3. Increase Public Health Spending
More of the GDP can be directed into health spending. New funding will allow developing infrastructure, buying state of the art technology and/or rolling out health programs.
4. Simplifying Health Policies
Terms and conditions can be simplified to make health insurance clearer, easier to understand and even more acceptable in patients/home-users/process.
Conclusion
India’s healthcare problems are real, but not insurmountable. By implementing meaningful healthcare policy reform and improving the surrounding insurance system, India can become a more equal, efficient, future-focused system. There is no doubt that demand for affordable health-care is growing in India, the question is, when will we start? Together, let’s create a stronger, healthier nation.
Reference
https://www.livelaw.in/articles/problems-with-medical-insurance-in-india-analysis-293238
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