Even though Indian households tend to spend a lot on healthcare, only 34% of the population had any health insurance before the pandemic. Often, the insurance people had provided inadequate coverage and had a limited number of healthcare facilities in its scope to avail treatment. However, two facets have been added to the Indian healthcare scenario in recent years. One is local, the rising income level, and the other is global, the onset of Covid-19.

A study concluded in 2020 showed a compound annual increment of 16.4% in the spending on health by Indian households from FY 12 to FY 19. This growth was directly attributed to rising income levels and urbanization. Later, Covid-19 acted as a catalyst modifying healthcare delivery and general health behaviour. Suddenly, general wellbeing, immunity, and healthcare costs became immediate concerns.

A couple of missing aspects that came resurfacing during the pandemic were that of health insurance and telemedicine. The government’s flagship health insurance scheme, Ayushman Bharat, got much-needed momentum in giving healthcare access to the proposed 10-crore households, offering a hospitalisation cover of Rs 5 lakh. However, with the global limelight on the spread of Covid-19, we must not forget about the increasing prevalence of non-communicable lifestyle ailments in India, such as cancer, cardiovascular diseases (CVDs) and diabetes, etc.

During the past three decades, the number of deaths from CVDs in India has doubled. Getting a chronic illness treated implies increased healthcare expenditure, which is likely to drain one’s entire life savings if one is not covered under any insurance scheme. In recent years, healthcare costs are pushing 50-60 million people into poverty every year. In a study, the Public Health Foundation of India (PHFI) indicated that healthcare expenses drove 55 million Indians into poverty in 2017. Out of these, 69% were exhausted by expenditure on medications alone. Hence, healthcare companies and insurance providers, both in public and private domains, must collaborate on making policies and finding ways to provide affordable healthcare.

Ensuring Insurance

Improved access to health insurance needs to be an immediate priority as it is critical in sharing and alleviating the financial burden of patients. Insurance providers need to come up with better coverage plans. And we, as healthcare providers or administrators, need to foster a robust health insurance marketplace ensuring that patients secure affordable and adequate coverage. One way to do this is to encourage health insurance plans that cover OPD expenses.

A major chunk of expenditure for patients with chronic diseases comes from monthly medications and OPD visits. If we want people to buy or renew their insurance, we need to offer them benefits they can reap on a daily basis. For instance, after getting covered under health insurance in the USA, one pays just 5-7 USD for a medication that otherwise would cost 50-70 USD. Insurance providers in India should aim to bring policies that offer similar benefits. We must encourage healthcare stakeholders and policy makers to oppose health insurance plans that do not guarantee protections against pre-existing ailments. Insurance policies must offer essential health benefits without putting any annual or lifetime limits on healthcare expenses. Further, the insurance providers must stabilize their health insurance premiums without undercutting any existing patient protections.

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Contact-less but Efficient Care at Home

Another critical step that we must take to ensure affordable healthcare is to bring telemedicine into the mainstream. It is an efficient and extremely safe alternative to visiting hospitals, especially when a patient has ongoing treatment for a chronic ailment. The convenience telemedicine offers to the patient is invaluable as it eliminates the need for travel and prevents the patient from getting any communicable disease inside a healthcare facility. By September 21, 2021, 12 million teleconsultations have happened through the Health Ministry’s eSanjeevani telemedicine service since its launch in November 2019. And it is imperative we keep making constant efforts to provide healthcare access to the patients while they are in the comfort of their homes.

Hospitals must take initiatives to participate in providing digital access to healthcare as promoted by the Govt of India under its various healthcare outreach programs. For instance, they must set up robust internet/Wi-fi systems at hospitals and provide adequate training to doctors to use teleconferencing apps and keep the patient's information secured. Cybersecurity is a key facet to look at while offering telemedicine.

About Author

Ms. Upasana Arora is the CEO and Director of Yashoda Super Specialty Hospital (Ghaziabad). A charismatic personality and dynamic leader, Ms. Arora approaches healthcare with empathy and compassion. She advocates for patients’ safety and affordable healthcare while ensuring seamless care to the needy.

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