Page 183 - India Insurance Report 2023- BIMTECH

India Insurance Report - Series II 171

2.4 Expand Health Insurance Coverage : The government should work towards expanding health
insurance coverage to all citizens. This would help reduce out-of-pocket expenses and make healthcare
more affordable.

2.5 Prioritize Primary Healthcare : Strengthening primary healthcare is crucial for achieving UHC.
This includes increasing access to primary healthcare facilities, improving the quality of care, and
strengthening the primary healthcare workforce.
2.6 Improve Healthcare Quality : Quality of care is an important aspect of UHC. The government
should invest in improving the quality of care by developing quality standards, ensuring adherence to
these standards, and providing training to healthcare providers.

2.7 Invest in Health Information Systems : Health information systems play a crucial role in UHC
by providing data for planning and monitoring healthcare services. The government should invest in
developing robust health information systems that can provide timely and accurate data.

2.8 Promote Preventive Healthcare : Investing in preventive healthcare can help reduce the burden
of disease and the cost of healthcare. The government should promote preventive healthcare measures,
such as vaccination programs, health education campaigns, and lifestyle interventions.
2.9 Foster Partnerships : Achieving UHC requires a collaborative effort between the government,
healthcare providers, and civil society. The government should foster partnerships with healthcare
providers and civil society organizations to achieve UHC.

3. Conclusions

The current situation calls for radical reforms in the healthcare system with regard to national
healthcare programs and delivery, medical education and training and financing of healthcare. There
are three areas to focus :

First, to carry on the promise of the National Health Policy by ensuring availability, access, and
utilization of high-quality primary care through government health services. Only one-fourth to one-
third of outpatient care is sought in government facilities in urban and rural areas, respectively, despite
the availability of free or low-cost treatment for a wide range of primary care services. Researchers have
pointed to issues like poor quality of care, long wait times and high health worker absenteeism with the
government-provided services, driving people – poor and rich alike – to private care. The public sector
needs to be made accountable for providing accessible and efficient primary care and integrating it with
secondary care under PMJAY.

Second, there is virtually no insurance product available for outpatient care. The inclusion of out-patient
packages in insurance policies, including in PMJAY, can help improve financial protection. As a starting
point, diagnostic services and preventive check-ups targeting common non-communicable diseases can be
included in the benefits package. They will improve the chances of a complete cure, in addition to preventing
cost escalation, by enabling earlier identification and management of NCDs. However, appropriate mechanisms
will have to be designed to incentivize providers to focus on preventive rather than curative care.