There has been a lot of discussion of late about health insurance and its economics. The basic problem is that hospitals charge far more money from patients who have health insurance, and health insurance companies are bleeding as a result. It is common knowledge that private reputed Indian hospitals (regardless of whether they are actually good) tend to charge breathtaking fees and they charge even more when the bill is footed to an insurer. The insurance industry wants hospitals to charge less, or else they would remove them from the cashless list. Hospitals, on the other hand, claim that providing quality healthcare services involves high cost and the Insurance Regulatory and Development Authority (IRDA), predictably, thinks that the solution lies in insurance customers paying more to insurance companies.
However, hidden behind these conflicting opinions is an alarming fact — our dysfunctional public health system. This, combined with the profit-driven insurance and the healthcare industries, will inevitably add up to disaster, no matter which way the current crisis move.
The facts are very simple. Around the world, people’s access to reasonably-priced and good quality healthcare is linked to the viability of their countries’ universal public health systems. Unless, a large number of people are content with zero-priced (or close to zero-priced) government doctors and hospitals, there is nothing to keep the private healthcare and health insurance industry honest. What we are seeing right now is a battle between the two for cornering a bigger share of the money they shake down the patients for.
That the patients are going to be shaken down hard is a given. And the ultimate blame lies not with the insurers or the private healthcare providers, but with the state of public healthcare. Mostly, people will pay any amount of money to any alternative rather than choose among all but a handful of elite government hospitals. If you want to see which way we are headed, look at healthcare quality statistics of developed countries. The less functional the publicly-funded universal healthcare, the more the dependence on private insurance and private healthcare, the worse is healthcare delivery. Without anyone saying so aloud, this is a battle that seems already lost in India.