Ayushman Bharat is publicized as country’s largest health insurance scheme, but it may not be able to fetch a big deal for the Indian leading insurers. All the general insurance companies were expecting to play a major role in this flagship health scheme, Ayushman Bharat. Insurance companies have botched to get any significant share of the Ayusman Bharat. The proposal is being carried out by the state governments and most of the state governments avoid the domestic insurance companies and found trusts to execute the mission. So, the insurance industries are failing to bag any substantial share from this National Health Protection Mission (NHPM).
How Ayushman Bharat could be Helpful?
India’s Prime Minister Narendra Modi unveiled that this National Health Insurance scheme, Ayushman Bharat, would be launched on September 25th. And this scheme would offer 5lakh health coverage and covers over 1200 procedures that include all secondary and most tertiary diseases such as diabetes, all types of cancer and heart diseases to the poor and susceptible families of India to making it the world’s largest public health insurance program. This National Health Protection Scheme aims to cushion the poor from mounting healthcare costs as insurance infiltration is low at 3.49 percent in India against 6.28 percent globally. While it was announced, it was expected that the entire leading insurer in India would be the key coordinator of this wide-ranging scheme, which has an estimated premium sum of ₹100 billion in the first year itself. However, a month prior to the scheme’s launch, it looks like the proposal won’t generate a lot of business for the insurers.
National Health Protection Mission Was Not So Effective for the Domestic Insurers
Health insurance is a must from all walks of life and there is no second thought as it provides risk coverage for expenses caused by unanticipated medical emergencies. Health insurance companies play a key role in such circumstances and help the individuals to wrestle with the increasing cost of medical treatments. But whenever State Government has preferred the trust model for operating the National Health Protection Scheme which envisages a premium outlay of over Rs 10,000 crore, the insurance firms got disappointed. Hence, it is now clear that National Health Protection Mission (NHPM), which was anticipated to be a gigantic business for the domestic general insurance industry, is turning out to be damp squibs for the insurers as state governments prefer the trust model.
How This Scheme Will Work?
According to the sources, 26 states have signed the memorandums of understanding with the government to partake in the scheme. But out of 26 states, only 4 states — Jharkhand, Nagaland, Manipur and West Bengal have the standard insurance model. As per the present scheme, in a trust-based model, every individual state will form its own trust to supervise the system and claims will be distributed from a corpus created from Central and state government contributions at a ratio of 60:40. And the Third Party Administrators will settle the claims. This NHPM was the flagship program of Narendra Modi and will be the cushion for poor as it helps to survive them against rising healthcare costs.