Health Insurance: Rethinking India’s Healthcare System

06 Apr 2022

COVID-19 has been a watershed moment in the healthcare system. Over the last two years, the pandemic exposed the healthcare eco-systems of even the most advanced economies, costed millions of lives globally and – shifted norms of the ‘normal’ itself. In parallel, it has engendered the need for a multi-stakeholder focus on healthcare and triggered a step jump in self-awareness levels amongst people. Overall, COVID-19 has pushed the envelope of rethinking the entire healthcare system. 

As India also plans to revamp the healthcare system in the wake of COVID-19, it is important to set a clear and bold vision – the one which places the patient at the center of the care. We envision a futuristic journey where the patient gets democratized access to quality healthcare across the care continuum irrespective of his location, income, age or gender. We need to make this journey a universal reality – where we can provide ‘quality health care’ to ‘all’ individuals, which is ‘accessible anytime, anywhere’ at an ‘affordable cost’. Comprehensive insurance coverage throughout the care experience is key to this ideal patient journey. 

The economic impact of better health, globally, could add USD 12 trillion to the global GDP by 2040. These gains that could be potentially garnered steers the global economic recovery through the pandemic, but more importantly, can also aid in our demographic fight with an ageing population. 

Our renewed understanding on the effect that health carries on society, and the larger macroeconomy requires us to pivot in the way we have delivered health to our nation. Building an ecosystem that is not fragmented and can help deliver effective health outcomes throughout any season is what India should strive towards creating.

CII Health Insurance group has worked closely with various members and actively engaged with the Government towards achieving framework modules to strengthen healthcare delivery in India. CII has intensified its engagement with Ministry of Health & Family Welfare (MoHFW), Insurance Regulatory and Development Authority of India (IRDAI), NITI Aayog and the State Governments. 

CII has also initiated series of enabling payer provider discussions where the main focus is on common pain point other than pricing. This has 2 working groups, one from insurance and other from hospitals, who are working on topics like customer experience, discharge policy etc. This will also lead to a common platform with one voice involving all healthcare stakeholders. 

Globally, countries are progressing towards Universal health coverage as laid down under UN Sustainable Development Goals. However, health insurance in India is highly underpenetrated at just 35% of the population, of which majority is covered under Government-sponsored health insurance schemes. 

The high out-of-pocket healthcare expenditure is taking a heavy toll and pushing 4% of the population below poverty line every year. Further, the havoc created by COVID-19 pandemic has brought to the forefront the need for universal health insurance coverage. As a nation, today, we have the opportunity to build on and scale our efforts to transform health insurance in India. 

The Vision to Insure health of billion Indians by 2025 is a bold one and the imperatives include awareness through large-scale campaigns and creating pull for health insurance, curating comprehensive product portfolio catering to different segments, improving value proposition by driving better outcomes and lower costs, building distribution muscle for last mile access, and leveraging technology and data to improve efficiency in underlying healthcare and insurance infrastructure. Additionally, this journey will be accelerated by designing favorable policy and guidelines to spur efforts by multiple stakeholders in the ecosystem.

Read the full CII report ‘Healthcare 2021’ at

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