COMPARISION OF HEALTH INSURANCE

IN INDIA AND CHINA

 Healthcare Scenario in India
 High mortality, negligible Mother and Child Health
care.

 Urban-Rural population ratio- 70:30

 High population Size of the country.

 Declining funds to HealthCare Sector-Central

Government / State government.
 Healthcare Scenario in CHINA
The lack of access to affordable healthcare

Inefficient use of healthcare resources

A lack of high-quality patient care.

Vast population
 The income gap between the rich and poor has
widened and the “marketization” of medical
services has led to a decline in equity and access.

 Although more than 95% of health facilities are

public hospitals, 90% of operational funds are
dependent on fees-for-service

 The government spending was less than 20% and

that user fees from consumers were nearly 60% of
total health expenditure
 HEALTH CARE FINANCING IN INDIA
The share of public financing in total health care is
just about 1% of GDP.

Over 80% of the total health financing is private

financing, much of which is out-of-pocket payments.

Public financing of healthcare comes largely from

state government budgets, about 80 per cent, and the
balance from the Union government (12 per cent) and
local governments (8 per cent
 Healthcare Financing In China

 Over 80% of the population of china lives in villages

and are engaged in agricultural activities.

 In China, the health financing system consists of the

basic medical insurance scheme (BMIS),1 the urban-
resident scheme (URS),2 the new rural cooperative
medical system (NRCMS)3 and the medical
assistance programme (MAP).
 Health Insurance In India

 Indian health insurance industry stands at INR 5,125

crores with only a small Section of the total
population (around 2%) being covered so far.

 Health Insurance industry in India is one of the

fastest growing segments
 Health Insurance In India

Public Sector Insurance Private health Insurance

 Public Sector Insurance India
 CGHS Schemes for Government Employees
 ESIC Schemes
 Recent Initiative - covering mass populace PAN India
 RSBY
With participation of health insurer
Implemented in 11 states
Extended to other section of populace other than BPL
 State Government have also initiated several schemes
where there is participation of Insurers to run the Scheme
 private Sector Insurance India
 The passage of the Insurance Regulatory and
Development Authority (IRDA) Act in 1999 allowed
entry of private entities into the insurance sector.

 At least twelve commercial health insurers have

launched health insurance products to the market.

 According to the Ministry of Health and Family

Welfare, about 1.5–2.0 percent of the population
has subscribed to private health insurance.
India Health Insurance Market Size & Growth Rate

Market Size: (INR) - Crores

6000

5125
5000

4000
CAGR – 35% 3209
3000

2222
2000 1732
1354
1004
1000 761

0
FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 FY 2007 FY 2008

Market Size: (INR) - Crores

 Health Insurance In CHINA
 Only 15% of the population in the formal sector is
covered by social health insurance.

 The majority of rural and urban residents, children

and immigrants are not covered by any health
insurance system.

 Health financing in China is extremely inequitable

and health-care coverage is limited.
 Health Insurance In China

Social Insurance Private Health Insurance

 Social insurance
Social insurance is a mandatory, non-profit social
security system established by law in China. It is
administered by the labour and social security
departments.
The Ministry of Labor and Social Security (MOLSS)
launched the Urban Employee Basic Medical Insurance
(BMI).
For rural segments of the population, the voluntary New
Cooperative Medical Scheme (NCMS).
There are five types of social insurance in China: old-
age, medical, unemployment, work-related injury and
child-bearing.
 PRIVATE SECTOR INSURANCE
 Private health insurance was reintroduced during
economic reforms of the early 1980s and is now regulated
by the China Insurance Regulatory Commission (CIRC).
 In the past few years, at least eight commercial health
insurers, led by Ping An and China Life, have introduced
more than 700 health insurance products to the market,
most as supplemental policies to BMI and the NCMS.
 According to a 2003 Ministry of Health survey, about 6
percent of the urban and 8 percent of the rural population
in China have subscribed to some form of private health
insurance
 CHALLENGES OF HEALTH
INSURANCE IN india
 Healthcare costs
 Regulation of providers
  Consumer Awareness and Empowerment
 Minimizing moral hazard in the system
 Increasing reach, access and affordability
 Product and delivery innovations, innovations in
distribution
  More comprehensive products
  Increased specialization and professionalization in the
system
 CHALLENGES OF HEALTH INSURANCE
IN CHINA
 Despite some legislation on medical insurance
reform in China, the health insurance system’s lack
equality and lack of government funding.

 A second issue is the split between the rural and

urban systems.

 Another major issue challenging China’s progress in

creating a successful health insurance system is lack
of supervision over the health care sector.
 INDIA & CHINA
SIMILARITIES AND DIFFERENCES.
 SIMILARITIES
Both the countries lack the fiscal resources
required for universal coverage.
Lack of affordability is a major issue in both the
countries.
High rural population which results in lack of
awareness and generalized acceptance.
Both the countries are rapidly developing,
leading to a high rise in healthcare
expenditures.
 Both the countries have similar disease patterns.
 DIFFERENCES

They are dissimilar in terms of their political regimes

and policies that govern health insurance.

Differences in the tax benefits from health

insurance.
 CONCLUSION
 Surveys suggest that over the past five to ten years, a
variety of public and private insurance schemes have
played a important role in enabling health care provision
for unique populations in these two countries.
 In terms of funding access to health care, the Chinese
state has traditionally supported most costs, whereas
private insurance has always played a major role in India.
 China has, arguably, had more success than India in
providing health insurance, although recent reforms
have severely impacted upon the ability of the Chinese
health care system to operate effectively.
THANK YOU