Centre may set up regulator for healthcare to expand insurance coverage

A regulator for the healthcare sector is expected to bring in standardisation and lower the costs

The Centre is considering establishing a health sector regulator which will also provide budget-friendly health insurance coverage for all citizens, reported The Economic Times (ET), citing senior officials. They said that the health and finance ministries have discussed the need for a watchdog.

According to the ET report, the Centre is conducting these discussions under its vision of "Insurance for All". Officials said that the steps are required to expand health insurance while keeping it affordable for the masses.

The report also cited data from the National Insurance Agency which showed that over 400 million individuals do not have access to health insurance or have inadequate coverage. They are facing risk at a time when healthcare costs are going up.

A government official was quoted in the report as saying, "There are various challenges and opportunities, such as standardisation of treatment costs and settling health claims, that can be addressed by a sectoral regulator in the health insurance segment."

Another official said that the Department of Health and Family Welfare under the Ministry of Health is now expected to call a meeting of all stakeholders, which will include insurance companies, to come up with a detailed plan.

The report also said that a health regulator can further broaden the scope of the National Health Claims Exchange and can be entrusted with more powers to function like an industry watchdog.

The Insurance Regulatory and Development Authority of India (IRDAI) regulates insurance providers that provide health coverage among other products.

As things stand, the pricing of health insurance is determined by market forces but there is a great degree of difference across insurers in policy terms and claim restrictions and limits. A health regulator is likely to bring in standardisation and lower the costs.