The global pandemic of COVID-19 has brought about the healthcare system of India to the central stage. As per reports, India hardly spends about 1.5% of its Gross Domestic Product on the healthcare systems, lowest amongst all the countries across the world. In the month of June in the year 2021, a report on ‘Health Insurance for India’s Missing Middle’ was launched by NITI Aayog. This report claims that about 30% of the Indian population do not get any financial security for their healthcare services.
As per the reports, the Ayushman Bharat Scheme provides coverage to approximately 50% of the Indian population. Approximately 20% of the Indian population is covered under voluntary and social health insurance. The remaining 30% of the Indian population is devoid of any kind of financial protection for their healthcare treatment procedures. This segment is referred to as the ‘missing middle’ since they aren’t poor enough in order to be covered by the schemes subsidised by the government. However, they aren’t rich enough in order to afford the private health insurance policies. The actual number of individuals who are uncovered is much greater because of the existing gap of coverage in the Ayushman Bharat scheme.
India has extended strides towards the Universal Health Coverage by launching the ‘Ayushman Bharat’ Pradhan Mantri Jan Arogya scheme in the month of September in 2018. This scheme is considered to be the largest scheme which is subsidised by the government in the whole world. It provides coverage to about 50% of the Indian population. It also caters to about 10.9 Crore families or about 49 Crore people who are categorised in the Socio-economic Caste Census 2011. The scheme of Ayushman Bharat provides healthcare packages which are subsidised and provide an annual coverage of about Rs. 5 Lakhs each family as per the floater basis. Since the scheme has a limitation of covering about 50% of the total Indian population at the pyramid’s bottom level, an average middle class Indian continues to face a lack of access to healthcare treatment.
Mediclaim Vs Health Insurance
COVID-19 pandemic has opened up the gap that must be given attention to. Before understanding about the factors which make it difficult for India’s ‘Missing Middle’ to receive high-quality healthcare, let’s understand the difference between Mediclaim and Health Insurance. This is necessary to be aware of because of the inflating medical expenses which can cost you an entire life savings as well. Hence, it is advisable to get yourself insured in order to protect yourself from paying hefty treatment amounts.
Here’s the Mediclaim vs Health Insurance differences:
| Mediclaim | Health Insurance |
| Mediclaim offers financial coverage against the hospitalisation expenses only | Health insurance provides a comprehensive cover which extends beyond just hospitalisation expenses, comprising OPD expenses, alternative treatments AYUSH, annual health checkups, and daily hospital cash |
| No add-on covers | Several add-ons covers including the Maternity Benefit, Critical Illness Cover, Infertility Cover, and more |
| Not flexible | Flexible and customisable |
Factors Making It Difficult for India’s “Missing Middle” to Receive High-quality Healthcare
The five factors making it difficult for India’s “Missing Middle” to receive high-quality healthcare are as follows:
1. Lack of Infrastructure
The COVID-19 pandemic has shown that the healthcare system of India is not prepared for any kind of unexpected catastrophic events which may be similar to COVID-19. The gap between supply and demand, government’s budget on the healthcare systems, and the chronic shortages of healthcare are few of the concerns which must be addressed immediately. As per reports, data has suggested that India has only 1.4 beds for every 1,000 individuals, 1 doctor for every 1,445 people, and 1.7 nurses for every 1,000 individuals. There is a huge lack of proper infrastructure to accommodate the Indian population which is over 1 billion people.
2. Disparity in the Healthcare Systems of Rural and Urban India
As per reports, more than 75% of the infrastructure of the healthcare system is situated in the metropolitan cities, where hardly 27% of the Indian population lives. The remaining 73% of the population of India lacks even the basic medical infrastructural facilities. The primary medical centres lack more than 3,000 doctors, and in the span of the last ten years, the shortage has risen by approximately 200%. The quality healthcare treatment can generally be found in the metropolitan or urbanised cities, however, the Indian population residing in the rural areas cannot afford to travel to these cities for their treatments.
3. Lack of Skilled and Trained Resources
The average doctor-patient ratio is 1:1445 which has a huge gap that can be alarmingly concerning. As per the Indian Journal of Public Health, India must have obtained about 20,70,000 doctors by the year 2030. However, a government hospital’s doctor is required to attend to approximately 11,000 patients. This number is way more than the ratio of 1:1000 as recommended by the World Health Organisation (WHO).
4. Expensive Healthcare Treatment
The medical processes such as those involved in the treatment of cancer, several types of transplants, as well as the critical ails must be given immediate attention. The government hospitals are already overburdened with a lot of patients to attend to and hence, they end up failing at delivering timely treatment. This diverts the individuals to seek for healthcare in the more expensive private hospitals.
5. High Pocket Expenses
Approximately 63% of the medical costs are spent by the Indians out of their own income or savings. This is considered to be the maximum rate with respect to the whole world. As per reports, about 7% of the population of India is annually pushed into the world of poverty because of the Indian healthcare system and the expenses involved.
Medical crowdfunding has evolved as one of the alternative options of medical financing for the ‘Missing Middle’ of India. It is commonly seen in India that people are generally drained out of their entire life’s savings in order to meet their medical exigencies. In some cases, most people are not even provided with a promise of getting recovered. technology in India, the donation procedure has become more convenient as well as transparent. However, the crowdfunding industry of India has just come into limelight and it is seen that the tier 2 or 3 cities have a sizable potential. If the population opts for the correct collaborations, awareness campaigns, education drives, it is believed that a significant transformation can be achieved and brought about in the lives of the rural Indians as well.
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