The government has made a new health plan for the population of more than 40 crores deprived of the facilities of medical insurance in the country. The government has also shortlisted 21 insurance companies for this. The government is planning to sign an MoU between the National Health Authority (NHA) and insurance companies before the start of this pilot project. These companies will offer more subsidized cover to the families.
At present, about 50 crore poor families are getting the benefit of Pradhan Mantri Jan Arogya Yojana. In this, the entire family gets an insurance cover of Rs 5 lakh. The senior government official said that the companies will give ‘PMJAY clone cover’ to 40 crore additional people on a voluntary basis. He said that these group covers will be for those families who do not have any medical insurance. This will also be a big step towards ‘Universal Health Coverage’ (UHC).
Apart from 50 crore poor people of PMJAY scheme, 3 crore people are covered in different schemes of the states. 15-17 crore are included in central schemes like ECHS, ESCI and CGHS. Whereas, 14 crore people have chosen the way of getting insurance in private companies at their own expense.
Even after this, more than 40 crore people are left out, who do not have any kind of medical cover. They have been called ‘Missing Middle’. This means those people who cannot buy insurance themselves nor can they get the benefit of the government scheme. The government feels that due to lack of medical cover in view of Kovid, these ‘missing middle’ may fall victim to poverty due to health expenditure. In a recent presentation, a senior advisor to the National Health Authority had enumerated many reasons for not buying medical insurance cover, including lack of awareness, low coverage, expensive products, expenses.
The names of 21 companies shortlisted include Max Bupa Health Insurance Company Limited, Royal Sundaram General Insurance Company Limited and many big companies. These companies have been asked to provide information. This includes information about the proposed group they are looking to cover, their geographic location, product information, premiums, hospitals, among many other things.
Example of foreign
India has obtained information about many examples from abroad regarding UHC. In a recent presentation to the government, it was said that Brazil, Britain, Norway, Denmark, Greece, Portugal, Italy and Spain have made eligibility universal and provided tax-financed and subsidized coverage to the poor. Countries such as Thailand, Indonesia and Vietnam have extended subsidized cover to the poor and at-risk groups. Whereas, Chile has decided to offer service packages to everyone without insurance status.
Russia and Kazakhstan have also used revenue streams to increase entitlement to health rights, regardless of employment status. However, having a population of 130 crores is a big challenge for India.