A parliamentary committee recommends accelerating the rollout of standardised, low-cost health insurance aimed at middle-income households, highlighting gaps between public schemes and private market coverage and calling for reforms to reduce out-of-pocket expenses and enhance healthcare accessibility.
A parliamentary committee has urged India to speed up the rollout of standardised, low-cost health insurance for middle-income households, arguing that this group often falls between public welfare schemes and the private market and is left exposed to large bills after medical emergencies. In its 176th report on the affordability and accessibility of healthcare in the public and private sectors, tabled in the Rajya Sabha on August 7, the Department-related Parliamentary Standing Committee on Health and Family Welfare said the middle class needs “robust, accessible safety nets” and called for wider products modelled on Aarogya Sanjeevani with simpler terms and broader coverage.
The panel also pressed for uniform, transparent treatment packages across all hospitals, saying patients should be able to predict costs before treatment begins. According to the report, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana has already covered more than 11 crore hospital admissions and empanelled 38,038 public and private hospitals, with treatments worth Rs 1.57 lakh crore approved under the scheme. It said those gains must be protected from medical inflation and sharp rises in technology costs, and recommended a legal mechanism to update package rates regularly, taking regional cost differences into account so private hospitals remain involved without cutting quality.
The committee linked its recommendations to the wider strain of private healthcare costs, noting that average out-of-pocket spending per hospitalisation episode stood at Rs 34,064 and that medical inflation has been running at 10% to 13% a year. It recommended removing room-rent-linked inflation models for standard procedures, setting statutory guidelines for treatment protocols and limiting arbitrary price variation. On medicines and consumables, it called for Jan Aushadhi Kendras in every remaining block-level public health facility and for more private tertiary hospitals to host AMRIT pharmacies, which sell discounted implants and surgical items.
Beyond insurance and pricing, the panel urged states to lift health spending to at least 8% of their total expenditure, with the Centre using incentives to encourage compliance. It also backed the inclusion of Ayush treatment packages under AB-PMJAY without any out-of-pocket cost for beneficiaries, alongside tighter integration of private providers into the Ayushman Bharat Digital Mission. The report said recent reforms, including the removal of upper age limits for buying policies and a shorter waiting period for pre-existing diseases, should be enforced more strictly, while Tele-MANAS and eSanjeevani should be expanded to improve access to specialist care in remote areas. It added that out-of-pocket spending as a share of total health expenditure fell from 62.6% in 2014 to 43.4% in 2022-23, while per-capita government health spending rose from Rs 1,108 to Rs 2,786 over the same period.
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