The global push for universal health coverage in the Emerging Markets is gathering pace, driven and stewarded by the World Health Organisation (WHO). In India, revolutionary health insurance systems have already granted access to 37 million of the poorest and most marginalised families. Brazil’s “expanded right to health”, Mexico’s “Seguro Popular” and Thailand’s universal coverage scheme are just three other examples.

But these efforts have flagged up a number of issues. For one, there is no single UHC model applicable across health systems, societies and economies. National wealth, social inequality and public attitudes to health will all influence the chosen policy. Disease burdens differ remarkably not just across countries but also within them. Some societies run straight for the surgeon, others avoid intrusive procedures for as long as possible.

You then have to figure out how to pay for it and who is going to provide it. This is where private operators and insurers begin to enter the picture.

UHC policies will focus on the poor with little means to pay for healthcare themselves. And are therefore predominantly government funded. But many are making use of the private insurance market to boost administrative capacity and to try to keep a lid on prices. India’s RSBY tenders insurance contracts out to the private sector in each state. PMI is incentivised to lower prices and increase coverage by a DRG pricing system and premiums paid to each new client.

The state will also struggle to meet the demand for treatment and capacity will also have to grow. Those who were previously excluded from healthcare are not just poor, but also often sick and bring a different burden of disease to the chronic, lifestyle conditions of the well-heeled classes. Private operators are bringing forward innovative and efficient solutions to meet this demand across the world. From Indian group Narayana’s heart surgery to the growing role of telehealth.

Regulating the market has been an issue in the past, but increasingly private operators in emerging markets have international accreditation.

If private healthcare remains a luxury good the market will continue to move towards over-servicing and increasingly medicalised societies. But by capturing new UHC clients, private operators can access almost unlimited opportunities. And secure a reputation for private healthcare as a necessary and beneficial part of the healthcare landscape.

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