Private Health Insurance in India

Abstract

Health care in India is severely underfunded and neither the Government nor the common citizen has the financial ability to pay for quality medical care. Given this situation, private health insurance should have a wide acceptance in the market and play a significant role in meeting the health care funding shortfalls. But in reality, the sector has been mired in restrictive regulations and outdated business models and continues to operate under losses, in an unsustainable mode. Consequently, the health insurance industry needs to relook their business models and evaluate emerging concepts in health care that can help correct the imbalance and help the industry operate in an effective manner. Some of the models which the health insurers need to evaluate are the managed care model, integrated model and the accountable care model (ACM). These models will help the health insurers address the core issues of health care costs and quality management and help the sector respond to the industry challenges. Although, these models have been in use in other countries, Indian health insurers need to factor in the local con-text and ensure that models work effectively for all stake holders and successfully meet the country’s health care challenges.