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HomeCentral GovernmentComprehensive Health Insurance Regulator: A New Hope for India’s Healthcare Sector

Comprehensive Health Insurance Regulator: A New Hope for India’s Healthcare Sector

New Delhi: The Centre is considering establishing an independent health sector regulator exclusively for the health insurance sector and will provide budget-friendly health insurance coverage for all citizens. The Ministries of Finance and Health are currently in discussions regarding the need for a dedicated watchdog for this sector. The Centre is conducting these discussions under its vision of “Insurance for All”. Officials said that the steps are required to expand health insurance while keeping it affordable for the masses.

A recent report by the National Insurance Agency revealed that over 400 million individuals, approximately a third of the population, lack health insurance. This is attributed to lower penetration, inadequate coverage, and escalating healthcare costs. This group of population are facing risk at a time when healthcare costs are going up. A government official was quoted in the report as saying, “There are various challenges and opportunities, such as standardisation of treatment costs and settling health claims that can be addressed by a sectorial regulator in the health insurance segment.” Another official said that the Department of Health and Family Welfare under the Ministry of Health is now expected to call a meeting of all stakeholders, which will include insurance companies, to come up with a detailed plan.

The report also said that a health regulator can further broaden the scope of the National Health Claims Exchange and can be entrusted with more powers to function like an industry watchdog. Presently, the Insurance Regulatory and Development Authority of India (IRDAI) regulates insurance providers that provide health coverage among other products. As things stand, the pricing of health insurance is determined by market forces but there is a great degree of difference across insurers in policy terms and claim restrictions and limits. A health regulator is likely to bring in standardisation and lower the costs.

Meanwhile, the Association of Healthcare Providers India (AHPI) has welcomed this development, indicating a positive response from the healthcare industry. The government’s vision of ‘Insurance for All’ is driving this initiative, with a focus on increasing health insurance penetration and maintaining affordability. The proposed health regulator is expected to address these challenges and bring forth opportunities such as standardisation of treatment costs and efficient settlement of health claims. The Department of Health and Family Welfare, under the Ministry of Health, is expected to convene a meeting of all stakeholders, including insurance companies, to discuss a detailed plan and the role of the potential health regulator. This move signifies a major step towards improving the health insurance landscape in India, aiming to make healthcare more accessible and affordable for its citizens. As the discussions progress, the nation awaits further developments in this crucial sector.