Rising Healthcare Costs in India: Challenges and Strategies for Affordable Health Insurance

In India, the healthcare expenses, such as the costs of medical treatments, procedures, equipment, and medications, have been shooting up in recent years due to several factors. Furthermore, the growing population in the country has caused a surge in the demand for healthcare services, further contributing to the escalating cost of healthcare. Apart from this, the shortage of healthcare professionals and facilities in India has further intensified the rising healthcare expenses. Despite having one of the largest populations, we still face a shortage of doctors, nurses, and hospitals. Consequently, overcrowding and longer waiting periods for medical treatments become unavoidable, which further leads to rising healthcare costs. This article elucidates the health insurance challenges we as a country face and the strategies for affordable health insurance coverage in India.

Health Insurance Challenges in India

The Indian healthcare system is constituted of two main sectors -- public and private. Private healthcare services in India are of good quality but often unaffordable for the majority of the low-income population. On the other hand, the public healthcare sector faces many challenges like inadequate infrastructure and a shortage of healthcare professionals. Government hospitals in rural areas are particularly underserved due to insufficient facilities like buildings, instruments, and professionals. However, the Indian healthcare system is gradually changing with advancements in technology and the emergence of Public-Private Partnerships (PPPs). These improvements and collaborations in medical facilities are enhancing accessibility and helping in the early detection and prevention of many chronic health conditions.

Apart from the issue of accessibility, affordability is another interconnected and fundamental challenge in the healthcare sector. A substantial portion of the Indian population lacks health insurance coverage, forcing them to bear the expenses out-of-pocket when accessing healthcare services. Many government programs and private health insurance plans do not cover significant costs such as medical tests, medications, and post-surgical expenses. We all have witnessed the shortcomings and gaps in the healthcare ecosystem during the Covid-19 pandemic.

In spite of the growing demand for healthcare, there is a scarcity of healthcare professionals in India, leading to an expanding gap in the doctor-patient ratio. This situation significantly affects the accessibility of healthcare, particularly for individuals residing in rural areas. This imbalance is expected to worsen in the future due to population growth. Moreover, the deficiency of doctors and trained medical staff hampers the delivery of health services. To address the disparity between availability and requirement, India needs to prioritise the training of more paramedic professionals.

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Here's How Health Insurance Companies Help in Making Healthcare Affordable:

1. Health insurance companies negotiate with healthcare providers and pharmaceutical companies for providing medical treatments and medications at reduced prices, aiming to make them more affordable for patients.

2. Health insurers encourage people to prioritise preventive care by offering coverage for the expenses of regular check-ups and vaccinations. This helps in detecting illnesses at an early stage, which can prevent them from developing into more serious conditions.

3. Health insurance companies can promote the use of telemedicine, which makes healthcare more accessible and convenient for patients.

4. Health insurers can effectively assess the necessity of healthcare treatments and procedures by using techniques like utilisation review, and prior authorisation. These methods help in assessing the necessity of treatments so that unnecessary treatments can be prevented.

How Can You Make Your Health Insurance Affordable?

Here are certain steps you can take to make your health insurance coverage more affordable:

1. Make Healthy Lifestyle Choices:

Making good lifestyle choices is the best way of maintaining good health, which ultimately helps in keeping healthcare costs down. Engaging yourself in regular physical activities like walking and jogging can help you maintain a healthy weight and reduce stress. Similarly, having a balanced diet with plenty of fruits, fresh vegetables, and lean proteins can lower the risk of chronic diseases. Besides, making healthy lifestyle choices can also positively impact your mental health. Whereas unhealthy habits like smoking or excessive drinking can increase the likelihood of developing critical illnesses like cancer, lung disease, and liver disease and treating these conditions can be expensive.

2. Use Employee Wellness Programs:

Employee Wellness Programs are beneficial for individuals to save money on healthcare costs. These programs are created to encourage healthy behaviours and offer resources and rewards for employees to maintain good health. Many employers include wellness programs as part of their employee benefits package, which can provide various services and resources such as health coaching, gym memberships, stress management workshops, and programs to quit smoking. Furthermore, many employee wellness programs offer preventive health screenings like cholesterol or blood pressure checks. These screenings help identify health issues at an early stage, preventing them from becoming more severe and costly to treat.

3. Compare Healthcare Providers:

Comparing healthcare providers before seeking medical services is a practical approach to saving money on healthcare expenses. The cost of medical procedures and treatments can vary greatly among different providers. For instance, the price of a routine blood test or MRI scan can be significantly lower at one facility compared to another. Hence, it is recommended to conduct research and compare prices before scheduling any medical procedure or treatment. A quick online search can help you discover the most affordable options for medical services in your city and nearby areas. Numerous websites allow you to compare prices and assess the quality ratings of different healthcare providers in your locality. Additionally, you can reach out to your insurance provider and request a list of network hospitals to compare their prices.

4. Buy Health Insurance Coverage

Health insurance is a form of insurance that offers protection against unexpected medical emergencies caused by injuries, illnesses, or accidents. It covers expenses related to medical treatments such as hospital bills, medications, and doctor's fees. One of the key benefits of having health insurance is access to preventive care services. Many health insurance plans offer free or low-cost preventive treatments, including annual check-ups, vaccinations, and screenings for various illnesses. Hence, it is advisable to buy adequate health insurance coverage to safeguard yourself and your loved ones from unforeseen medical costs that may arise due to illness or injury.

When buying a health insurance policy, it is crucial to understand and compare different plans and their coverage. Some plans provide comprehensive coverage for a wide range of medical treatments, while others offer partial coverage and may require higher out-of-pocket expenses. Consider factors like annual premiums, deductibles, and co-payments associated with each plan. Furthermore, it is recommended to review your policy's terms and conditions annually and stay informed about the covered services to maximise the benefits of your health insurance policy. By doing so, you can protect yourself from unexpected medical expenses and ensure that your health insurance policy is working effectively for you.

5. Use Generic Medicines:

Opting for generic medications instead of brand-name equivalents is a practical approach to lower healthcare expenses. Generic medications are equally safe and effective as brand-name drugs, but they generally come at a much lower cost.

When a pharmaceutical company develops a new drug, it is protected by a patent for a specific period, during which no other company can manufacture or market the drug. Once the patent expires, other companies can produce and sell the same medication, known as a generic drug. Since generic drug manufacturers do not have to invest in research and development or marketing, they can offer the medication at a significantly lower price.

While generic medications are more affordable, make sure they still meet the same standards of safety, quality, and effectiveness as brand-name drugs. Individuals can consult their doctors about the availability of a generic version of their prescribed medication without worrying about compromising their health. Choosing generic medications can lead to substantial reductions in healthcare costs.

6. Use Telemedicine Services:

Many healthcare professionals now offer telemedicine services, allowing patients to connect with them remotely through video, phone, or messaging technology. This approach is becoming increasingly popular and can be a practical and affordable way to receive medical care, especially for routine or non-emergency visits. One of the major advantages of telemedicine is the time and money it can save for patients. They can avoid the need to travel to a healthcare facility or spend time in a crowded waiting room since appointments can be conducted from anywhere with an internet connection. Additionally, telemedicine appointments often tend to be less expensive as they typically require fewer resources and staff compared to in-person visits.

However, take note that healthcare billing procedures can sometimes be complex and confusing. To avoid excessive costs or overlooking important expenses, patients should carefully review their healthcare bills and familiarise themselves with terms like insurance coverage, co-payments, and deductibles. By taking an active role in understanding and questioning their medical expenses, individuals can ensure they receive the best care at the most affordable price.

7. Negotiate on Medical Bill:

One way to ensure healthcare remains affordable is by engaging in negotiations to lower medical costs. Negotiation involves discussing the price of medical services with the healthcare provider or billing department in order to reduce the overall bill. While many people believe that medical bills are fixed and cannot be altered, this is not always true. Healthcare practitioners and billing departments may be open to negotiation, especially for patients without insurance or experiencing financial difficulties. Negotiating can involve requesting discounts, proposing payment plans, or even seeking the waiver of certain fees.

To effectively negotiate medical bills, patients should be prepared by conducting research, understanding their insurance coverage, and communicating clearly with the healthcare provider or billing department. Seeking assistance from a hospital bill representative can also be considered, as they can aid in negotiations and ensure that the bill is accurate and fair. By engaging in negotiations, patients can successfully reduce their healthcare costs and alleviate financial burdens. It is important to maintain a respectful and honest approach during discussions and promptly fulfil any agreed-upon payment arrangements to maintain a positive relationship with the healthcare provider.

Conclusion:

The increasing expense of healthcare in India is a complex issue affected by various factors. These include the rising costs of medical treatments and equipment, the shortage of healthcare professionals and facilities, inadequate insurance coverage, the absence of proper regulation and standardisation in the healthcare industry, and high out-of-pocket expenses for patients. To prevent financial strain, it is crucial to manage healthcare expenses effectively. By following these tips and strategies, individuals can take control of their healthcare costs and ensure they receive the necessary care without facing financial hardship.

KETKI JADHAV is a Content Writer at PersonalFN since August 2021. She is an MBA (Finance) and has over seven years of experience in Retail Banking. Ketki specialises in covering articles around banking, insurance, personal finance, and mutual funds and has been doing it for over three years now.

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