“Low government spending on health has constrained the capacity and quality of health services in the public sector. This diverts most of the individuals – about two-thirds – to the costly private sector to seek treatment,” said NITI Aayog in its report on health insurance. India’s Missing Middle Released on Friday.
According to the report, Ayushman Bharat or Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), launched in September 2018, and state government expansion schemes, provide comprehensive hospitalization cover to the bottom 50% of the population, or 70 crore individuals . 20% of the population or 25 crore individuals are covered through social health insurance, and private voluntary health insurance.
“The rest 30% of the population is devoid of health insurance. The report said that PMJAY has a higher actual untouched population due to existing coverage gaps and overlap between schemes.
The report suggests a comprehensive product or improvement design on Aarogya Sanjeevani such that the new product provides early coverage of all diseases, provides outpatient benefits and should be available at one-third to half the cost of Aarogya Sanjeevani, Which is currently priced at Rs 12,000. A family of four.
According to the report, the government can play an important role in increasing health insurance and addressing some of the challenges. First, the government must improve consumer confidence and confidence in health insurance through a stronger regulatory mechanism. Second, it can provide government data and infrastructure as a public good to reduce operating and distribution costs for insurance companies.
“Ultimately, and most directly, the government may partly finance or provide health insurance,” it said, by expanding PMJAY coverage to the poorest segments of the missing middle population and offering voluntary national health insurance. This can be done by taking advantage of the PMJAY infrastructure of the Authority. Contributory Enrollment.