India recently announced an ambitious plan called the National Health Protection Scheme (NHPS) to provide government-sponsored insurance to roughly 500 million people or nearly 40% of India’s population.
Why NHPS is a good idea:
- India under-invests in the healthcare of its citizens and this is affecting the health and financial well-being of Indians.
- The NHPS should be considered a significant move towards universal health coverage. Health-financing policy directly affects the financial protection of people when direct payments that are made to obtain health services do not threaten their living standards.
- While not all insurance programmes are successful, there is sufficient evidence that if implemented well, insurance can save lives and improve financial well-being.
- The study conducted on the Vajpayee Arogyashree Scheme (VAS) of Karnataka found that VAS lowered mortality for covered conditions for BPL families and erased rich-poor disparities in mortality rates.
- Existing evidence shows that providing insurance to the poor not only saves lives but is also “cost-effective”. It provides good value for money as the benefits of insurance far outweigh the costs.
Ensuring the success of the programme:
- Make insurance easy to use: Insurance that is difficult to use will not be used. Therefore, we need to streamline both the enrollment process and access to care once enrolled.
- Access to care should be provided where people live. This is a challenge in rural India but can be addressed with innovative models.
- Target low-income populations: The government sponsored insurance should be provided only to those who cannot afford insurance on their own.
- Contract with private hospitals and clinics: Nearly 75% of out-patient department care and 55% of in-patient department care in India is exclusively from the private sector. Therefore, private hospitals and clinics provide care to a large fraction of the population and they need to be part of NHPS.
- Use data to learn and evolve: The NHPS will have access to health information of 500 million people. This is an unprecedented amount of data and if curated well, it can have far-reaching applications. It can be used for comparative effectiveness research or understanding which treatments work in the real world rather than just in clinical trials.
- Tracking the NHPS will be extremely important to set priorities and shape future health policies in India. In a large and diversified country, health needs differ from state to state, and, within a state, can vary greatly from one district to another.