Counting the cost of universal health coverage
We find ourselves writing once again about universal health coverage this week, both in Indonesia where it has been introduced to large swathes of the population already, and India, where progress has been made but the initial programme has been delayed at least a month beyond its (now missed) launch date of last Wednesday.
In Indonesia, it’s a work in progress, but real progress has been made. Almost three quarters of the fourth most populous country in the world now have access to healthcare through a mandatory insurance scheme. This is creating opportunities – and unlike Europe where there is concern about who is delivering treatment, the focus in emerging markets is far more on the how and when. Private operators can benefit.
And indeed the private sector in Indonesia is growing – but we hear regulations limiting foreign investment are talking their toll, as subscribers can read more about this week. The challenge going forward will be to see how more accessible – and poorer – parts of the country can be catered for. Striking the right balance of private / public patients, and between payments falling and volumes increasing, has been a steep learning curve for many.
In India, the second most populous country in the world, they are several years behind this progress – and we hear there have been greater concerns about possible delays in payment and dis-allowances. Pricing controls have been contentious for years too. This does not encourage investment.
It is against this background you have to consider the delay in implementing the start of the health insurance scheme. Instead of the launch, Prime Minister Narendra Modi renamed the scheme (for the second time) which has been dubbed ‘the world’s largest healthcare programme’. It isn’t that – not yet at least – as the programme targets only those most in need.
The delay may be logistical. Around 7,500 hospitals are understood to be signed up to participate while 10-12,000 are needed. One of the biggest problems facing both countries is a lack of foreign investment. Indonesia might do well to relax its rules restricting this – and India bring in rules to encourage and reassure such investors – if they want to see the road to true UHC traversed more quickly.
We would welcome your thoughts on this story. Email your views to David Farbrother or call 0207 183 3779.
