Page 178 - India Insurance Report 2023- BIMTECH

166 India Insurance Report - Series II

The primary aim of the National Health Policy 2017 is to inform, clarify, strengthen and prioritize
the role of the Government in shaping health systems in all its dimensions - investments in health,
organization of healthcare services, prevention of diseases and promotion of good health through cross-
sectoral actions, access to technologies, developing human resources, encouraging medical pluralism,
building knowledge base, developing better financial protection strategies, strengthening regulation and
health assurance. NHP 2017 builds on the progress made since the last NHP 2002. The developments
have been captured in the document “Backdrop to National Health Policy 2017- Situation Analyses”,
Ministry of Health & Family Welfare, Government of India. India needed a comprehensive healthcare
policy to address the complex healthcare challenges, keeping in view the developments in the healthcare
sector and the changing demographics. The ‘National Health Assurance Mission’ came with a clear
mandate to provide universal healthcare that is not only accessible and affordable but also effective and
reduces the OOP spending for the common man.

Universal Health Coverage (UHC) is widely discussed worldwide as an essential component of the
development agenda. The outbreak of Covid-19 has necessitated the need for universal health coverage
as the health systems failed miserably across the globe during those times. Considering the importance
of UHC, the United Nations declared 12th December as International Universal Health Coverage Day
(UHC Day) in 2017. The United Nations defines UHC as “everyone, everywhere should have access to
the health services they need without risk of financial hardship. ”Sustainable Development Goals target
3.8 (“Achieve universal health coverage, including financial risk protection, access to quality essential
healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines
for all”) also focuses on achieving universal health coverage.

But it was only in 2018 that the government of India displayed a serious commitment to healthcare
by launching the ambitious Pradhan Mantri Jan Arogya Yojana (PMJAY). Popularly known as Ayushman
Bharat, it brings all the economically vulnerable sections of the society under the umbrella of health
coverage, including the unorganized and self-employed class of carpenters, cobblers, transport workers,
domestic workers and labourers as well as other disadvantaged people who happen to be just above the
poverty line. The program extends easy access to healthcare facilities to around 53 crore individual
beneficiaries in the form of coverage of Rs. 5 lakh per family per year and makes both secondary and
tertiary hospitalization completely cashless.

The National Health Authority (NHA) was constituted as an independent body under the Ministry
for Health and Family Welfare and is charged with executing the Ayushman Bharat scheme. It also
proposes to set up 1.5 lakh Health and Wellness Centers to provide quality primary care along with free
medications and diagnostic services.

A broad expansion of the Ayushman policy is in the works now. It aims at providing a health
insurance framework to around 45 crore people from the as-yet missing middle class who are otherwise
not eligible for PMJAY, ESI and other state health coverage. The NHA is inviting proposals from
private insurers to provide group insurance plans in coordination with the government – the target is to
offer the lower middle class a low premium amount at roughly one-third of the market rates.

However, it is quite disappointing that this time again the outpatient healthcare has been left out of
the net, which actually forms a major chunk of the out-of-pocket medical expenses. While new wellness