Universal insurance focused on high-cost diseasesAchi News

In order for each family to have such protection in the form of insurance against health care costs, many families must come together to share in these risks. This can only be achieved when everyone is able and willing to purchase health insurance and pay the necessary premiums. This is not natural even in developed countries. So governments should help.

Recognizing this, most state governments in India already offer free health insurance plans, which are paid for by taxes. These plans work with thousands of hospitals, and insurance pays all patient expenses.

This is great news, but it comes with two problems: a) the current insurance plans cover many conditions but only 30% to 40% of the population because of the very small amount allocated to them; And, b) even for those that do, insurance plans carry high limits that are insufficient to cover the full cost of treatment for many major illnesses.

As a result, almost half of the payouts in these plans are below Rs 7,000 per incident, which is very small, which makes sense, with only a small (4 per cent) of the claims being above Rs 1 million. Is this a good use of an already tight government budget? Or is it like trying to teach everyone to swim to save themselves from drowning, which while useful involves a lot of wasted effort when you give them life jackets?

Given that government funds are limited and the need for protection universal, state governments would do well to use that money to provide an insurance scheme that covers their entire population (poor and non-poor). A limited number of very expensive and very rare cases. Knowing they have this coverage gives all of their people peace of mind and peace of mind, even though many never use it. And, since the cases covered are rare, even if they cost thousands of rupees each, the total amount required will still be within the allocated budget.

Providing this insurance coverage allows state governments to take the time they need to build stronger health care systems with the rest of the budget. These can provide free care to their residents (dengue, diabetes, hypertension) and to everyone for everyday conditions that their insurance plans do not cover. With this new type of insurance, the government can take solace in the knowledge that if any family faces a major setback in their health, the boat will not sink and no life will be lost.

If everyone is automatically registered, the need to check and recheck people’s identities and registration status—a major problem in the current system—will also be eliminated. Covering the entire population allows state governments to use their purchasing power to negotiate lower prices for more expensive conditions. In addition to helping the plan to maintain prices for high-cost conditions in large hospitals, it will have a significant impact on all health care costs, ultimately making it much cheaper for them to build a health care system that covers all conditions.