PM's National Insurance Scheme on the Anvil: Minister of State for Health

Hon. Mr. Faggan Singh Kulaste, Minister of State, Ministry of Health & Family Welfare, has called for continuous dialogue with all stakeholders, including health and insurance industry for successful implementation of Prime Minister's National Health Insurance Scheme currently being considered.

The Minister said that the PM's insurance scheme would be a game changer in coverage and enhanced benefits.

Mr. Kulaste stated that the present scheme for people below poverty line (BPL) operated under Rashtriya Swasthya Bima Yojana (RSBY) has expanded the national health insurance scheme with more than 75% coverage. The new scheme would entail larger financial commitment from the government. The private health and insurance industry could partner in creating more facilities for treatment of patients, such as leveraging idle beds in private hospitals.

The minister also said that the new national insurance scheme would dovetail fragmented schemes to make the project more homogeneous and impact-oriented. The primary objective of the government is to make health services universal and accessible. He added that the government would monitor implementation of the scheme through data and share it with industry.

Mr. P J Joseph, Member (Non-Life), Insurance Regulatory and Development Authority (IRDA), said that number of people covered under health insurance has touched 36 crore now, mostly under government schemes. New IRDA guidelines, such as provision for pilot products, which allow insurance companies to withdraw a project if it fails to click in the market, allowing wellness and preventive packages, permitting offer of discounts etc. have been introduced to expand coverage. Insurance companies could bring down premium if the number of people covered under the scheme increases.

The IRDA Member called for a strong regulatory mechanism and Intellectual Property Rights (IPRs) for insurance products. He said that there should be concerted efforts to prevent frauds and unethical practices.

Dr Naresh Trehan, Chairman, CII Healthcare Council and CMD, Medanta-The Medicity, stressed addressing issues such as steep administrative charges levied by the insurance companies, transparent hospital billing, wrong and high pitched claims etc. With the launch of the Prime Minister's national insurance scheme, business opportunities would go up considerably. We have to earn people's faith in the system to expand our business horizons, he added. Stress should be on managing care through preventive and wellness measures, he said.

Mr Neelesh Garg, Co-Chair, CII Sub -Committee on Accessibility-Health Insurance & CEO & MD TATA AIG, underscored the need for evolution of an ideal sustainable universal health insurance architecture which should include OPD, post hospitalization coverage, wellness package etc. The integrated package should be for the entire lifecycle of a person and cover all possible eventualities relating to health and wellness.

Mr. A Vaidheesh, Chairman, CII Sub-Committee on Accessibility -Health Insurance & Vice President South Asia & Managing Director, India GSK, observed that an ideal health insurance ecosystem for India should have more private players. Only six crore people are covered under private insurance schemes, which should go up substantially.

Mr. Segar Sampathkumar, Mentor & Co-Chairman CII Sub-Committee on Accessibility-Health Insurance & General Manager, New India Assurance Co., highlighted customer satisfaction and sustainability as the key drivers of growth of health insurance sector in India.

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