The case for universal health insurance for the entire Indian population is stronger than ever before, and the question now is how to make it workable and feasible To say that everyone falls sick or needs to see a doctor, at some point or the other during life, is stating the obvious. But when we are talking about a country with more than one billion people, the sheer numbers whose needs have to be met are mind-boggling. Equally staggering are the amounts of money spent on the healthcare of such a large population. The value of medicines bought and sold in India each year is about Rs30,000 crore. Given that medicines constitute just about 25 per cent of the total health expenditure in the country, the aggregate works out to be about Rsl,20,000 to Rsl,50,000 crore (up from Rs68,000 crore in 2001). Compared with this, the annual health budget of the Central government is slightly above Rsl6,000 crore. To this is added, the expenses incurred by the various state governments which is believed to be another Rs20,000 crore. Thus the public expenditure on healthcare is barely one-fourth of the total expenditure, and most of this comes from the budgets of individual people and families. No surprise then, that at least 24 per cent of the population that needs hospitalisation each year is pushed below the poverty line because of the costs of being in hospital. In real terms, this means about 10-12 million people are no longer able to support themselves financially after they get back home after hospitalisation. Therefore, the case for universal health insurance for the entire Indian population is stronger than ever before, and the question now is how to make it workable and feasible. All insurance companies, both government-owned and private, both foreign and Indian, realise this, and several industry reports produced by bodies such as CII (Confederation of Indian Industry) and Assocham (Association of Chambers of Commerce and Industry) emphasise the massive growth potential of health insurance in our country. Industry experts estimate that the health insurance market, which currently stands at about Rs5,100 crore, could expand to Rs28,000 crore by 2015. For this growth potential to become reality, a number of steps needs to be taken - measures that a CII-KPMG report of December 2008 described as "enablers of growth." Among these are: product and pricing innovation, technology and channel innovation. Other factors that would facilitate the growth of the industry, which the KPMG report describes as "pillars of change" include consumer awareness, standardisation and accreditation of healthcare providers, healthcare infrastructure and data exchange. "Standardisation of healthcare terminology, like names of disease conditions, is very important because it enables proper communication between healthcare providers and insurance companies," says Sanjay Datta, head of health insurance practice at ICICI Lombard. "Product and pricing innovation is expected to be the key driver for penetration of health insurance in India. Based on the consumer research it was evident that Indian consumers desire new products to be introduced in the Indian market. Product and pricing innovation increase the options available to consumers in terms of number of products available, diseases or illnesses covered, improve customer satisfaction, provide better access to cost effective and quality healthcare and reduce fraud," the report says. An interesting innovation on the product front, offered by international companies like CIGNA, and BUPA, is a package of healthy behaviours and lifestyle changes intended to improve the health of the insured persons. The "Health Active" scheme which ICICI Prudential introduced earlier this year, functions through a link on the Website of the insurance company and offers a variety of value-added services. It has a tie-up with the Welspring chain of diagnostic laboratories, which enables the 6,000-odd clients registered to get 10-30 per cent dis