Universal insurance scheme for India desirable
The universal health insurance programme, announced by the Union Ministry of Health and Family Welfare, has the potential to revolutionise the manner in which millions of people access healthcare in this country. If implemented effectively, it can bring quality healthcare services at nominal prices to even the poorest of the poor. As of now, only 25 per cent of the country has insurance coverage; the rest are unprotected and vulnerable to the extent that even one major road accident or a bout of serious illness can wipe out the savings of an entire family. And this is not just the case for those living in abject poverty; large sections of the uninsured middle class, for example, are also equally at risk of financial ruin in such situations. Against this backdrop, the Health Ministry deserves full credit for making health insurance a national priority. Universal coverage has been on the Government's agenda since Independence — however, for a variety of reasons, including the lack of finances, it has never been implemented properly. There are some smaller schemes that offer free or cheap health services to sections of the marginalised and the poor, but there is no country-wide scheme. Once initiated, this universal health insurance scheme will complement the Pradhan Mantri Jan Dhan Yojana, which seeks to promote financial inclusiveness in a country that still primarily functions in the irregular sector. The new plan is not exactly comprehensive but it will ensure that everybody has access to at least primary healthcare facilities. The scheme includes 50 essential drugs (that are expected to cover a significant majority of health problems), a set of diagnostic services and 30 AYUSH (ayurveda, yoga and naturopathy, unani, siddha, and homoeopathy) drugs at all Government hospitals.
However, for the scheme to be truly effective, the country's overall healthcare infrastructure has to be overhauled. As of now, it is woefully inadequate to support the healthcare needs of more than a billion people. The situation can become worse once the new scheme comes into play and the system is accessed by an increasing number of people. Also, let us not forget that lack of money is not the only reason why many in India can't afford basic healthcare. Almost all Government hospitals and healthcare centres provide either free or highly subsided services. Yet, that is still not good enough because of many problems that lie elsewhere — for example, in some cases, state-run facilities don't have adequate manpower or enough medicines or even basic medical equipment; in other cases, there are so few health centres in a particular area that it is not always feasible for patients in remote locations to travel long distances. Instances of critically ill patients dying en route to hospitals are tragically common. These are problems that will not be solved through an insurance scheme.
Another aspect that needs to be looked into is the role of the private sector in the healthcare delivery mechanism. Universal insurance will shift at least some of the patient burden on the private sector — this is fine, even desirable. However, the Government must ensure that the private sector is properly regulated so that patients aren't scammed or trapped by their insurance providers.