According to a report released by NITI Aayog, in the absence of low-cost health insurance products, at least 30 percent of India’s population or 400 million individuals are deprived of any financial protection through insurance. The report titled ‘Health Insurance for India’s Missing Middle’ said that expanding health insurance coverage is a necessary step and a pathway in India’s effort to achieve universal health coverage (UHC).
“The report states that at least 30 percent of the population, or 40 crore individuals, are missing centres, devoid of any financial protection for health… in the absence of a low-cost health insurance product, despite missing center capacity. remains open. to pay nominal premium,” it said. According to the report, the ‘missing middle’ is a broad category that lacks health insurance, located between the disadvantaged poor sections and the relatively well-organized sector. The report pointed out that the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) launched in September 2018, and state government’s expansion plans, provides comprehensive hospitalization cover to the bottom 50 per cent of the population of about 70 crore persons. Huh. About 20 percent of the population is covered through social health insurance, and private voluntary health insurance. “The rest 30 percent of the population is devoid of health insurance; the actual UN PMJAY has a higher population covered due to existing coverage gaps and overlap between plans.
“This overlooked population is called the missing middle. The report states that the missing middle is not a monolith, it contains multiple clusters in all expenditure quintiles,” the report said. “The missing central urban and all expenditure quintiles in both Is spread around in. Rural areas, though they are concentrated in the top two quintals of rural areas and the top three quintals of urban areas.”
According to the report, the missing middle constitutes a wide range of predominantly self-employed (agricultural and non-farm) informal sector in rural areas and informal, semi-formal and formal occupations in urban areas. Noting that most of the health insurance plans and products in the Indian market are not designed for the missing middle, the report states that private voluntary health insurance designed for high-income groups, costs less than the missing middle. At least two to three times the affordable level. . Affordable contributory products like ESIC, and government subsidized insurance including PMJAY are discontinued products, the report said, adding that “they are not available to the general population due to the risk of adverse selection.” NITI Aayog member (health) VK Paul, in the preface to the report, highlighted the need for health insurance coverage for all and said, “There will be a need to address significant challenges to increase access to health insurance.” He further said that the government and the private sector will need to come together in this effort. “The ingenuity and efficiency of the private sector is essential to reach the missing middle and offer attractive products,” Paul said.
The report noted that low government spending on health has constrained the capacity and quality of health services in the public sector. “This diverts about two-thirds of people to seek treatment in the expensive private sector,” the report said. The report said that less financial security leads to higher expenditure (OOPE). Poverty from catastrophic expenses, and costly visits to hospitals and other health facilities.
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