The Impact of Health Insurance in Low and Middle Income Families!

The Impact of Health Insurance in Low and Middle-Income Families!

India is still a developing country and doesn’t boast of world-class medical infrastructure to take care of every medical need of its citizens. The public medical service sector comprising of government hospitals, community health centers, etc. is present in adequate numbers, but without the desired infrastructure in terms of the latest equipment or trained staff. The onus thus falls on private health care and their cost of operations makes them prohibitively expensive from a common man’s point of view. Without having enough health insurance, getting treatment at a private facility is almost impossible.

Going by figures, less than one-fifth of India’s population, or only about 21.6 crore people comes under any health plan. Out of those eligible, nearly 70% get coverage by various government schemes. With such poor penetration of insurance products, it is no surprise that nearly 63 million people are going toward poverty every year. Most citizens are paying out-of-pocket (OOP) when it comes to availing of medical care.

The reason is an expensive medical treatment as non-communicable diseases have become almost 60% of the total illnesses portfolio. For example, the average cost of normal childbirth in a decent hospital in Mumbai is Rs. 40,000/-. Similarly, the average cost of angioplasty in Delhi is approximately Rs. 2.5 lakhs. These are average prices and if we consider medical inflation, it is growing at an average rate of 12-14% per annum. How is a poor person expecting to meet these heavy costs without an insurance plan?

For any health calamity, the patient’s family has to arrange funds on their own, whether from their savings, borrowings, or by selling their assets. Only if they are made aware of cashless health insurance along with other health plans can a better quality of life be expected of them.

No doubt the government is making efforts. The overall government spending on citizens’ health has gone up to 30% of total health expenditure and OOP has come down to 58%, but it is still high than global practices. However, the public sector’s contribution to health care is only 1% of GDP rather than going up substantially to cater to a growing population.

This is the reason the government’s sponsored health insurance schemes are slowly gaining ground. The most prominent one is the Rashtriya Swasthya Bima Yojna (RSBY), which is an inpatient health plan for the poor. Under this policy, the poor can get coverage for up to 5 members of the family for 700 medical tests and treatments at pre-fixed prices. The limit for total inpatient treatment is Rs. 30,000/-.

The most important thing to be considered is that having a health plan can help low-income and middle-income families tremendously. With family health insurance, one can live peacefully without having to worry about medical expenses in times of emergency. As the insurance sector tries to increase penetration in the hinterland of the country supported by efforts by various NGOs as well as awareness programs being run by the government, there is still hope. It is expected that ordinary citizens from the lower strata of society won’t have to sell or mortgage their assets to get medical care.

Not only does a health policy covers hospitalization expenses, but it also provides for pre and post-hospitalization coverage along with lump sum benefits in case of critical illnesses. Especially with cashless health insurance, one can get medical treatment immediately without having to worry about arranging cash for advance payments.

The way we have spent recent years, it was as if our existence was under attack. Kovid-19 has completely affected every area and let’s talk about India; Covid -19 has brought a lot and taken away a lot. Poor and middle-class families are the highest in India, so the arrival of Covid-19 was like a curse for them, if we talk about the fact, after the first wave of Covid-19, 10 Crore middle-class families in India, went below the poverty line.

A poor family earns daily and fills their stomach every day, no more than that they think nor do they expect more than that. If someone falls ill in poor family, then this problem becomes double for them, firstly, the cost of money for treatment which they usually do not have, and the second problem is that the poor has a government hospital available in the name of the hospital. Where it is a bit difficult to get the right treatment, we all know the reality of government hospitals and their dedication to serving the patient. Health policy plays a vital role, in terms of getting coverage and benefits of the policy.

It is as difficult for a poor person to go to a big hospital and get treatment as much as to survive the buffalo while living in a butcher. After 70 years of Indian independence, a poor person is getting of proper treatment in today’s time and this is the truth of India. Better treatment should be for everyone but it is a little different in India, but with the help of health insurance, all this can be possible. Having a health policy is a blessing, a poor family can get treatment in a big hospital.

For low and middle-income families in India, a health plan is a must. Whether one goes for individual health coverage or family health insurance depends on an individual’s needs. Here’s hoping that awareness makes people invest in health plans to secure their future rather than just save taxes!

Sonia Nagpal

Sonia Nagpal is an Insurance Specialist. She has more than 25 Yrs of experience in sales, Marketing and Corporate Alliances.

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