Better Regulations for Health Insurance

FICCI's Health Insurance Advisory Group offered a series of recommendations for standardisation of initiatives relating to various aspects of the policy to ensure better regulation.

These are aimed at streamlining issues currently faced by stakeholders such as 'standard definitions for critical illness' and 'standardisation of list of excluded (Non-medical) expenses in Hospital Indemnity Policy', Standard Treatment Guidelines, Billing Procedures and Discharge Summary; and Standardisation of HealthCare Provider-Insurer and Provider-TPA Contract.

The high cost of in-patient treatment, low health insurance penetration, and high out-of-pocket expenditure, places an insurmountable burden on individuals, particularly those below the poverty line and the aged population.

As per NSSO data, nearly 65 per cent of India's poor get into debt and 1 per cent fall into BPL category each year because of health issues.

It is also estimated that by 2025, 189 million Indians will be at least 60 years of age. Therefore, it is evident that affordability of healthcare across the pyramid is extremely pertinent and critical to achieve the goal of providing quality healthcare for the masses.

The long term vision to make quality healthcare affordable for the country should be to increase the health insurance penetration to at least 50 per cent of population by the year 2020 and 80 per cent by the year 2030 from current level of 15 per cent.

It is with this objective, that FICCI for the past three years, has strived towards creating a multi- stakeholder group supported by IRDA, with representatives from the World Bank, NABH, RSBY, healthcare providers and health insurance companies and other key stakeholders for convergence of various initiatives towards standardisation in healthcare and health insurance sectors.

Source: Medindia