Despite liberalization of the insurance sector, only around 21.6 crore people – less than one-fifth of India’s population – are covered under health insurance. Even among those who have some form of coverage, 67% are covered by public insurance companies, according to National Health Profile 2015, compiled by the Central Bureau of Health Intelligence.
The report, which has a separate chapter on health financing, shows despite a declining share of the Centre towards public health expenditure, it has done significantly well to provide insurance cover as compared to the private sector.
Public insurance companies have a higher share of coverage and premium for all types of policies, except the family floater policies, where private players grabbed 70% share. Family floater policies allow a family to claim the complete insurance benefit for one member of the family while the policy covers all its members.
Apart from the standard health insurance, around 15.5 crore people are covered under the three Central government-funded health schemes – Central Government Health Scheme, Employees’ State Insurance Scheme and Rashtriya Swasthya Bima Yojana.
A low public health spending coupled with poor health insurance penetration is reflected in India’s high out-of-pocket expenditure on health.
In rural India, almost 80% of the out-of-pocket expenditure is on medicine, whereas in urban areas it is around 75%. The doctors’ fee varies between 11 and 14 per cent and diagnostic tests account for 7-8 per cent of out-of-pocket expenditure.
In 2012-13, public expenditure on health was 1.08% of GDP, which has remained almost unchanged since 2009-10. The Centre-State share of that expenditure stood at 33:67. India’s public spending on health as a percentage of GDP is one of the lowest among countries of South-East Asian region – higher than only Myanmar – and the lowest among BRICS countries.
Government agencies and departments like the erstwhile Planning Commission in the past had pointed towards the need for a robust universal health insurance coverage to meet the increasing health demand.
Times of India