A fourteen-fold increase, amounting to 1500% is a considerable achievement over a 10 year period but the numbers represent an even bigger accomplishment. In 2004 only one percent of the population had access to health insurance. In terms of percentages this may amount to a tiny fraction, but when viewed numerically, even a percentage as small as one percent in a population of over a billion amounts to 10 million with insurance.
Recent articles on Health Issues India have focused on private health insurance policies, predominantly taken out by high net worth individuals. This new report shows that health insurance is on the rise beyond these groups, though on close inspection it may still be the case that the rise may be predominantly in wealthier states. This may be down to the different types of insurance policy on offer. The report indicates public health insurance was common across all states, so taking into account both private and public insurance schemes the more urbanised states will have a higher ratio of insured individuals.
The number protected by health insurance varies massively between states. Andhra Pradesh reports the highest number of those with health insurance, 62% of the population has some manner of insurance policy. At the opposite end of the scale, poorer states such as Bihar and Uttar Pradesh have an insured rate of 6.2% and 4.2% respectively.
Insurance policies and their quality may vary considerably between states: healthcare, and therefore health insurance, has always been a state rather than a Central Government concern.
Despite the increase in the number of people holding health insurance policies, i= out of pocket (OOP) expenditure has not gone down. The Report also found that poverty and catastrophic expenditures brought on by the cost of medical treatments did not fall for those with public insurance. This suggests either a lack of knowledge of how to utilise the policies, or simply low quality insurance schemes that do not provide adequate cover.
Publicly-insured people however were more likely to utilise healthcare facilities than the uninsured, indicating access to healthcare is improved with the possession of some manner of insurance.
Ideally it would be the case that government-provided insurance could provide adequate, and more balanced healthcare nationally without incurring OOP expenditure causing poverty. This is the aim set out in the National Health Policy (NHP), though in order to achieve this aim, a huge degree of government funding will have to be redirected towards the healthcare budget.