To accelerate the motive of Universal Health Coverage (UHC) – that is ensuring all people, everywhere, can get the quality health services they need without financial hardship – the United Nations celebrates Universal Health Coverage Day on December 12 every year.
Even as the UHC resolution was endorsed unanimously on December 12, 2012 and the celebration of the UHC Day started every year from 2014, the state of the healthcare system in India is not up to the mark countrywide yet.
Overcrowded government hospitals, poor conditions of state-run healthcare centres and lack of private hospitals with adequate facilities in rural India still defy the UHC’s motive of availing health coverage for all people everywhere in the country.
The high cost of treatment in private hospitals also defies the motive of availing quality health services without financial hardship.
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Lack of adequate infrastructure and connectivity, inability to direct checkups also create hindrance in the process of online medical counselling.
While advanced medical technologies – like Robotic Assisted Surgery (RAS) – try to bridge the gap, such treatments are not only expensive, but also demand adequate infrastructure with high-speed connectivity.
Healthcare experts explain how the private sector players are making healthcare more accessible in India:
Dr. Swapna Misra, Director, Obstetrics & Gynaecology, Fortis Hospital, Mohali
Gynaecological issues such as ovarian cysts and uterine fibroids are on a steep rise in India, especially due to increased changes in lifestyle management. We are seeing a lot of such cases in younger generation as well. Historically, the course of treatment for most of such cases is total hysterectomy which implies that the woman loses the ability to get pregnant. This can particularly be detrimental to the mental health of younger patients who want to retain their fertility.
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Robotic Assisted Surgery (RAS) using new-age systems like Da Vinci, via their precision arms and magnified viewing abilities, enables us to treat them without opting for the total removal of uterus, thereby preserving their ability to conceive in the future. However, a pertinent issue that is limiting the number of procedures performed is the inadequacy of knowledge about the benefits of RAS among patients. Another misconception that is commonly perceived by patients is that RAS is unaffordable, which is immensely inaccurate as the total cost of treatment for RAS is not higher than other modalities. To club with these, the insurance policies holding by most people have sub-limits for RAS, which is restraining them from fully accessing it. Hence, it is very important to enhance the awareness about the benefits of RAS among patients and payers to make it accessible to more people.
Mandeep Singh Kumar, Vice President and General Manager, Intuitive Surgical India
India’s healthcare sector has progressed immensely in the last decade. The key contributing factors have been the advancement of medical technology and expansion of health insurance schemes to offer some coverage to nearly 70 per cent of the population. To further support and catalyse this, Insurance Regulatory and Development Authority (IRDAI) has demarcated 12 contemporary therapies and technologies, including robotic-assisted surgery (RAS), that are now covered by both new and existing health insurance plans.
However, we still have some distance to cover when it comes to making these technologies accessible for all. For instance, in the case of robotic-assisted surgery, it can be observed that many health insurance policies have sub-limits, restraining full access to this new-age surgical method from the beneficiaries. One of the best ways to address this gap is by sensitising patients, providers (hospitals), and payers about the benefits of RAS in terms of better clinical outcomes and reduced total cost of therapy. Intuitive has been actively collaborating with surgeons and insurance providers to capture the value of robotic-assisted surgeries through quantifying the impact in terms of patient outcomes and creating a value dossier highlighting the clinical relevance of RAS and its cost-effectiveness. We are also actively reaching out to payers to drive conviction on the value of robotic-assisted surgeries by using Da Vinci, to help remove the sub-limits/capping for high-value RAS procedures. This will allow physicians to offer the benefits of RAS to a larger number of patients.
Karan Gupta, Co-founder and COO, Ayu Health Hospitals
While the Indian healthcare sector has experienced tremendous expansion recently, accessibility to quality healthcare has remained a problem for the vast majority of the population. Many people still choose to delay treatment and preventive checks stricken with the fear of the exorbitant bill that would be generated by the medical facilities. This makes access to high-quality healthcare even more difficult. Subscribing to a medical insurance can solve this problem to a certain extent. However, filing an insurance claim can occasionally be a difficult task.
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The lengthy processing period for payments is a significant problem that patients deal with in this regard. This happens even after the insurance company has paid them the amount and TPAs try their best to process at the earliest which leads to misunderstanding and tension between patients and hospitals. Patients are clueless and hospitals get disgruntled because of such disparities. As a measure to reduce such fuss, we, at Ayu Health have started our reimbursement financing solution, as a way to lessen inconsistencies in the system by financing the patients (through tie-ups with financiers) eliminating the burden of upfront payment to the hospital at the time of discharge. Additionally, we provide transparent packages with fixed prices, which makes our services to people from all income groups really accessible and hassle-free!