Is having insurance (private and public) really the answer to India’s healthcare issues?

Reading Dr Vikram’s post on “is-health-insurance-the-answer-to-indias-healthcare-woes?” made me think. Well, in the United States, despite healthcare being the highest capita spend of the GDP as per Organization for economic Co-operation and development (OECD) survey. But yet still we are unable to meet the healthcare needs of the population. That made me think – Is having insurance (private and public) the answer to India’s healthcare issues?

I would like to give my perspective whether we should invest heavily in insurance and the role of the government, based on my knowledge of Unites States healthcare systems.

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Understanding basics and challenges of U.S. Health Insurance and lessons India can learn from them

United States has predominantly two types of insurance – Private and Public.  Private health insurance is often offered through employers or other organizations. Public insurance is funded by government broadly through two categories – Medicare and Medicaid.  Medicare is funded through federal government for aged population who are age 65 or older. Medicaid is state-run government insurance program that helps some people with lower income for medical care.

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Is Health Insurance the answer to India’s healthcare woes ?

Well thats the question I have been asking myself all these years. Now seriously, the only country that spends 17 % of its GDP on healthcare and is ranked among the best healthcare systems in the world providing care to more than 300 million people is the United States of America. And the healthcare system there is run by Health Insurance firms.

India on the other side spends far lower, it is estimated that we spend about 5.7 % of its GDP on Healthcare. Almost 75% of it is in the private sector. As a matter of fact almost 80% of outpatients, pharmaceutical spend and ambulatory care is covered by the private sector. When it comes to inpatient it is 50-50 % with government and the private sector sharing the spend. It is only in the primary care and preventive space that government bears almost 95% of the spend. All immunization programs for example are run by the government.

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