Health Insurance for India’s Missing Middle
Polity & Governance
8th Nov, 2021
Recently, NITI Aayog in a report titled ‘Health Insurance for India’s Missing Middle’ suggested extending Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) coverage to ‘missing middle’.
Key-highlights of the Report
- Around 20 per cent of the population -- 25 crore individuals are covered through social health insurance, and private voluntary health insurance.
- The remaining 30 per cent of the population is devoid of health insurance.
- The actual uncovered population is higher due to the existing coverage gaps in PM-JAY and overlap between schemes.
- It is a Centrally Sponsored Scheme and the nodal agency to implement it is the National Health Authority (NHA).
- PMJAY provides cashless and paperless access to services for the beneficiary at the point of service.
- The AB-PMJAY and State Government extension schemes provide comprehensive hospitalization cover to the bottom 50% population (70 crore individuals).
- Around 20% of the population is covered through social health insurance and private voluntary health insurance.
- The remaining 30% of the population is devoid of health insurance; the actual uncovered population is higher due to existing coverage gaps in PMJAY and overlap between schemes.
Challenges in health sector for middle class
- Expensive treatment
- Lack of access to proper healthcare
- Inadequate reach
- Inadequate Fund
- Optimal Insurance
- No focus on Preventive Care
- Shortage of Medical Workforce
- Inadequate outlay for health
- Lack of structure
Important Government on Health
- National Food Security Act (NFSA)
- Pradhan Mantri Suraksha Bima Yojana
- Pradhan Mantri Kisan Samman Nidhi (PM-KISAN)
- Aam Aadmi Bima Yojana
Right to Health in India
- Articles 39, 41, 42 and 47 in the Directive Principles of State Policy (DPSP) contain provisions regarding Health.
- Article 21 provides for the right to life and personal liberty and is a fundamental right.