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NEW DELHI: At least 30% of India’s population – 40 million people – is still without any financial protection thanks to health insurance, even though its coverage has increased significantly in recent years with the launch of the government program Ayushman Bharat for the “destitute” families, according to a new report from Niti Aayog.
It stresses the need for a low-cost comprehensive insurance product designed for the “missing link” that is currently not covered by private sector regimes, state or central regimes, although it has the capacity. to pay nominal premiums.
“Voluntary private health insurance is designed for high-income groups – it costs at least two to three times the affordable level for the missing link. Affordable contributory products such as ESIC and government subsidized insurance including PMJAY are closed products. They are not available to the general population due to the risk of adverse selection, â€says the“ Health Insurance for Missing Center India â€report.
The ‘missing link’, located between the poorest sections and the relatively well-off organized sector, is mainly the informal sector of self-employed workers (agricultural and non-agricultural) in rural areas and a wide range of occupations – informal, semi-formal and formal – in urban areas.
The government think tank suggests that the private and public sectors create a modified and standardized product to cover all treatments for the disease as well as outpatient services as soon as possible. It also recommends extending PMJAY and ESIC services to this uncovered segment through low premium subsidized coverage.
“In the short term, the focus should be on expanding private voluntary insurance through commercial insurers. In the medium term, once the supply and use of PMJAY and ESIC is strengthened, their infrastructure can be leveraged to allow voluntary contributions to a PMJAY. plus, or to the existing medical benefits of the ESIC. In the long term, once the low-cost voluntary contributory health insurance market is developed, expansion of PMJAY to the poorest and uncovered segments of the missing link should be considered, â€the report said.
The participation of the National Health Authority which oversees the implementation of the PMJAY and the ESIC will also increase competition in the contributory voluntary insurance market, reducing premiums and improving the quality of care provided, the report said. report.
It stresses the need for a low-cost comprehensive insurance product designed for the “missing link” that is currently not covered by private sector regimes, state or central regimes, although it has the capacity. to pay nominal premiums.
“Voluntary private health insurance is designed for high-income groups – it costs at least two to three times the affordable level for the missing link. Affordable contributory products such as ESIC and government subsidized insurance including PMJAY are closed products. They are not available to the general population due to the risk of adverse selection, â€says the“ Health Insurance for Missing Center India â€report.
The ‘missing link’, located between the poorest sections and the relatively well-off organized sector, is mainly the informal sector of self-employed workers (agricultural and non-agricultural) in rural areas and a wide range of occupations – informal, semi-formal and formal – in urban areas.
The government think tank suggests that the private and public sectors create a modified and standardized product to cover all treatments for the disease as well as outpatient services as soon as possible. It also recommends extending PMJAY and ESIC services to this uncovered segment through low premium subsidized coverage.
“In the short term, the focus should be on expanding private voluntary insurance through commercial insurers. In the medium term, once the supply and use of PMJAY and ESIC is strengthened, their infrastructure can be leveraged to allow voluntary contributions to a PMJAY. plus, or to the existing medical benefits of the ESIC. In the long term, once the low-cost voluntary contributory health insurance market is developed, expansion of PMJAY to the poorest and uncovered segments of the missing link should be considered, â€the report said.
The participation of the National Health Authority which oversees the implementation of the PMJAY and the ESIC will also increase competition in the contributory voluntary insurance market, reducing premiums and improving the quality of care provided, the report said. report.
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