Burden of healthcare on poor

When it comes to health care, every individual dreads it. Health care costs are taking a large chunk out of the savings of an individual. These costs make the lives of poor people more vulnerable. Though India is becoming a destination for foreigners to avail affordable health care, many Indians find health care services unaffordable. The treatment costs are rising at a much faster rate than inflation for both rural and urban areas. Also inefficiency of government hospitals and pharmacies have led people to turn towards private players resulting in increased health care costs.

The private expenditure on health care is around 4% in India, which makes it one of the highest ranking countries when it comes to private expenditure on health care. However, major costs of healthcare are born by individuals rather than insurance companies or employees. 

A research paper in BMJ, a medical weekly, reported that 55 million Indians-more than the population of South Korea- were pushed into poverty because of out of the pocket health expenses between 1994 to 2014. Out of those 55 million, 69% (38 million) were impoverished due to expenses on medicine alone. This study also reported that 80% Indians incurred out of the pocket expenses in 2011-12 which was 60% in 1993-94. The contribution of medicines was more than 67% of these out of the pocket expenses in 2011-12.

Government has rolled out various schemes to ensure that poor people don’t have to bear the costs of medicine. However, as per study by India’s largest national survey on social consumption conducted between July 2017 and June 2018, reported that 90% of India’s poor population do not have any health insurance. Despite of many health insurance schemes like Rashtriya Swasthya Bima Yojana (RSBY, National Health Insurance Scheme), which was precursor of PMJAY, the central government health schemes for government employees, the Employee State Insurance Scheme for formal sector employees, the poor did not have any kind of health insurance.

The health insurance coverage in India is poor because the private health insurance industry has not yet developed in India and the number of people who are willing to pay for health insurance are very low. Also the insurance premiums are high which makes health insurance unaffordable by many poor people. In rural India, people have limited access to healthcare services like doctors and hospitals, thus they do not prefer to buy health insurance.

This condition led the government to roll out an effective scheme and the result was Ayushman Bharat- National Health Protection Scheme(AB-NHPS) in 2018. The scheme is targeted at following categories:

  • Poor
  • Deprived rural families
  • Identified Occupational category of urban workers’ families

Benefits of this scheme

  • This scheme defined benefit cover of Rs 5 lakhs per family per year for secondary and tertiary care hospitalisation.
  • There is no cap on family size and age under this scheme.
  • This scheme will be cashless and paperless in public and enlisted private hospitals.

With Covid-19, poor are facing a lot of issues and all they need is support majorly in financal ways.