More than 80 per cent Indians do not have any medical insurance cover, though they predominantly rely on expensive private healthcare for their medical needs.

Almost 86 per cent of rural population and 82 per cent of urban population are not covered by any scheme of health expenditure support, according to the National Sample Survey Office in its latest survey after interviewing more than 3,33,000 people.

The government was able to bring only about 12 per cent urban and 13 per cent rural population under health protection coverage through Rastriya Swasthya Bima Yojana and similar plans.

Only 12 per cent households in urban area had some arrangement of medical insurance from private providers. For all others, this share is negligible. In the absence of health insurance, 75 per cent people tap into their hard-earned savings while more than 18 per cent borrow.
Borrowing is more in rural areas compared to the cities, where the tendency is more to draw from the savings and household incomes.

“The private sector provides nearly 80 per cent of outpatient and 60 per cent of inpatient care. But the cost of private-sector health care is unaffordable for most Indians,” said K Srinath Reddy, president of the Public Health Foundation of India, in an article published in the July 1 issue of the “New England Journal of Medicine”.

When NSSO compared the cost of care at public and private sectors, it found while the private health care is four times more expensive than government-run hospitals and clinics in general, treatment of specific diseases cost four, five or even ten times more in private hospitals.

For instance, the obstetric and gynaecological problems, and child care is ten time costlier to treat in the private sector. Similarly, treatment of injury, gastro enteritis diseases, eye and skin problems and metabolic disorders like diabetes are 5-6 times more costly in private care.
Private institutions dominate the field in treating the in-patients for all these years, both in the rural and urban settings. A steady decline in the use of government sources and corresponding increase in the use of private sources are clearly seen over the last three surveys between 1995 and 2014. The changes were nominal in rural areas between 2014 and 2004.