India is a very interesting, unique economy in this world and there are many reasons for that. We are the country with the highest “working population”, we are a country with various traditional medical practices (which prove to work), we are a country with considerable number of people Below Poverty Line, we are a country, where in the last two decades have seen changes in our lives, livelihood, migrations and better quality of life.
With this, even the HealthCare landscape in India is changing. The model we follow is the “Out of Pocket Model”. Even though the Government has a very good spread for reaching each person in the Country, due to various factors, this does not work as expected. Private players are increasing and Technology is playing a bigger role in bridging the HealthCare needs to the common man.
Let us quickly examine the 4 HealthCare models on this Planet:
The Beveridge Model
This model is named after William Beveridge, the man who designed and developed the Britain’s NHS (National Health Services).
In this model, the complete Health Services are funded by the Government from the tax’s collected from public. The best example of complete Beveridge Model adoption is Cuba.
The Bismarck Model
This model is named after Prussian Chancellor Otto von Bismarck. This is an Insurance Model where employers and employees pay for Health Insurance through their payrolls. The Government holds a very strong control on the payout’s and hence the HealthCare costs are controlled. This is a pure “not-for-profit” model and this is the reason even though there are private Health Services, the costs do not go up.
This model is followed in Germany (where there are more than 200 funds which contribute to HealthCare services) and other European countries including Japan and Latin America.
The National Health Insurance Model
This is a combination of Beveridge and Bismarck models. This model uses private providers but funding comes from the Government’s Insurance Programs to which people contribute to. Since payments are controlled by Government, there are no denials/exploitations in the costs and services.
Best example for NHI Model is Canada.
The Out of Pocket Model
About 25% of countries in this world have an established HealthCare Systems are the remaining are Out of Pocket Models.
This is a straight forward model where you pay for the services utilised (Minimal/free in Government Hospitals and completely paid for in Private Hospitals).
Is it time we follow a model / combination of models / Create a Model for ourselves?
I think we should follow, “The National Health Insurance Model” where the government and public are working towards the Nations Healthcare.
It would be a very big policy change. Today, we are not exclusively paying for Health Insurance in India. We pay tax’s and Government decides to allocate funds to various programs.