India's Health-Care System: A Defining Juncture

India's health-care system faces the dual challenge of expanding access to underserved populations while maintaining affordability amidst rising costs. An integrated framework involving insurance strengthening, digital adoption, and sustained investment is essential to develop a health-care model that is inclusive, financially viable, and globally aspirational.

Insurance: Pooling Risk and Expansion

• Pooling risk is crucial for making costly care accessible, with modest premiums potentially unlocking coverage worth several lakhs.
• Current insurance penetration is low (15%-18%) compared to the global average (7% of GDP), highlighting a significant opportunity for growth.
• Gross written premiums are projected to grow at over 20% CAGR till 2030, presenting an opportunity to increase coverage.

Efficiency in Health-Care Delivery

• India excels at delivering quality care at scale, with innovations in doctor-patient ratios and workflow design.
• The focus should be on extending urban efficiency to underserved tier-2 and tier-3 cities.

Ayushman Bharat (PM-JAY) and Expanding Access

• PM-JAY has redefined access, covering nearly 500 million people with substantial family coverage for advanced care.
• To reach an additional 500 million, expanding private hospital participation with fair reimbursements is vital.

Preventive Health Care and Public Participation

• Insurance should cover outpatient and diagnostics, and there should be a strong push for preventive health care.
• Public participation is crucial; schools, employers, and communities must promote healthier lifestyles to prevent non-communicable diseases (NCDs).

Digital Health and Innovations

• India is leveraging telemedicine and AI to improve patient outcomes and the productivity of health-care professionals.
• Remote consultations and the Ayushman Bharat Digital Mission aim to democratize access and enable universal health records.

Regulation and Investment

• Robust regulation is needed to strengthen claims settlement and build trust in health insurance.
• In 2023, India's health sector attracted $5.5 billion in private equity, with a need to direct investment toward tier-2 and tier-3 cities.

Conclusion: A Right, Not a Privilege

India's health care is at an inflection point where insurance must cover everyday care, providers must scale efficiently, and technology must enhance access. With strategic investment and public-private partnerships, health care can become a universal right for all Indians.