India has a very poor health insurance penetration. Even
liberalization of the Insurance Industry has failed to attract
a single specialized health insurer till now. The concept
of TPAs and cashless hospitalization coverage was introduced
after liberalization with an aim to create a turning point
in health insurance. But there are many stumbling blocks
to create such a turning point. This paper aims to discuss
about the same.
India with a population of 1000 million, has a vast inequality
in terms of reach of the healthcare industry with barely
3% of the population covered by some form of health insurance,
either social or private. The guiding principle of Bhore
Committee in 1946-`no individual should fail to secure adequate
medical care because of inability to pay for it'-looks still
unreachable, even after more than five decades of independence.
The primary healthcare system in India is managed mainly
by a shallow structure of government healthcare facilities
and other public healthcare systems. The funding and provisioning
for healthcare also follows a traditional model. Such a
system is unable to fulfil the demand for health security
for the health insurable population, mainly due to exorbitant
service costs, absence of good and effective number of physicians,
low rate of education programs, less number of hospitals,
poor medical equipment and over all, low allocation of funds
by the government for health programs.
Even social insurance schemes, such as the Employee State
Insurance Scheme (ESIS) and Central Government Health Scheme
(CGHS), available in India have restricted coverage to a
very small segment of the population, something around 3%.
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