New Delhi, Mar 11 : Insurance Regulatory and Development Authority of India chairman Subhash Chandra Khuntia on Monday urged health insurance companies and healthcare providers to upgrade their standards and adopt ethical practices to provide access, equity and quality services to the people on a sustainable basis.
Speaking at the 11th FICCI Health Insurance Conference 2019 on the theme ‘Health Insurance 2.0: Enabling Change’, Dr Khuntia pointed out that access to quality health to majority of the people was essential as currently 62 per cent of the average health expenditure in India is borne out-of-pocket against the world average of 18 per cent. At the same time, health insurance companies and healthcare providers have to reach out to the uninsured in remote areas and provided facilities at affordable rates to the poor.
He also emphasised that standardisation of rates and procedures offered by healthcare providers was necessary and for this self-regulation for appropriate treatment was imperative till such time as a regulator for healthcare services was in place.
Towards this end, he advised insurance companies to have a MoU with healthcare providers to keep treatment rates in check. He also suggested that insurance companies could devise technological means to monitor the health parameters of policy holders to check lifestyle diseases such as blood pressure and coronary heart disease. This would go a long way in keeping premiums affordable as also reduce claims from the people at large.
Acknowledging that the life expectancy at birth had risen to 69 years in 2017, he said achievement of healthy life expectancy was an issue. For instance, the difference among female and male life expectancy and healthy life expectancy was 10.7 years and 8.1 years, respectively. Health insurance companies, he added, had a big role to play in bridging the gap.
Dr Khuntia also suggested that insurance companies could look at covering OPD and preventive care through various incentivisation schemes.
He said that IRDAI had launched a portal listing basic health insurance scheme and products which would be the same for all insurance companies. He urged all industry to make use of the scheme to take care of the misunderstandings of the provision of services offered to the buyer of an insurance policy.
National Health Authority CEO Dr Indu Bhushan described the health financing scenario as insufficient, inefficient and inequitable.
He said the government spending on health was barely 3.9 per cent of GDP, supporting 29 per cent of the population. The fact that out-of-pocket expenses in availing healthcare accounted for over 60 per cent of total expenditure speaks of the highly iniquitous and regressive form of financing in the country. Estimates show that over 6 crore people slip into poverty every year because of healthcare costs.
Dr Bhushan said the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) seeks to make healthcare financing more equitable even as he stressed the need for health financing to move to a pre-payment system rather than out-of-pocket spending. The heathy and the rich would have to take the onus of subsidising the unhealthy, elderly and the poor through risk pooling.
Ayushman Bharat which has completed 170 days since its launch has benefited 15 lakh people for which Rs 2000 crore has been provided for. The private sector had stepped in a big way and the coverage is expected to rise to 100 million in the next one year.UNI