Speed News Desk | Updated on: 23 August 2018, 11:14 IST

Headlines are being made everywhere since Harvard Business Review Press’ publication ‘Reverse Innovation in Health Care: How to Make Value-Based Delivery Work’ has come out, and it makes the mighty claim the Indian model of healthcare is inspirational and worth emulating in the West.

The changes and developments in the system have been lauded by all, with the influx of the best health insurance, excellent faculties and teams, and easy accessibility with the coming of endless government schemes like Aayushman Bharat.

But here’s a surprising fact about health insurance penetration in India:

According to a report by Central Bureau of Health Intelligence, only 27% Indians were covered under some types of health insurance policy in 2015-16. The report further reveals that around 80% of this population has opted for government-sponsored health insurance plans.

Before we delve any deeper, it makes sense to get acuminated to just some of the many government sponsored health insurance plans in India.

Ayuhsman Bharat or National Health Protection Mission (AB-NHPM):

Also, called a Modicare, Ayuhsman Bharat is a health insurance scheme by the Central Government, to be launched on September 25, 2018. The scheme will be launched on the pilot basis and aims to offer a free health cover up to Rs. 5 Lakh per family on yearly basis.

The aim is to provide a health insurance cover against most of the diseases that are prevalent in our country. It will be valid at all the public and empanelled private hospitals across India and covers both pre and post hospitalization expenses.

Central Government Health Scheme (CGHS)

This health insurance plan is available for central government employees, pensioners and their dependents living in one of the many cities covered by CGHS. Central government employees or pensioners looking to get health insurance coverage under this scheme can get a CGHS card made the office of Additional Director of the City. Alternatively, one can download application forms for the card from CGHS website too.

Employment State Insurance Scheme (ESIS)

Employees’ State Insurance Scheme is yet another government sponsored scheme that makes it easy for workers or employees to avail health insurance plans in India without having to run from pillar to post. Non-seasonal factories with 10 or more employees or establishments such as hotels, restaurants, cinemas, etc. that have 20 or more employees, private educational institutions and private medical establishments can avail this health insurance scheme. Under this scheme, the employer contributes 4.75% and employee contributes 1.75% for those earning monthly income less than INR 21,000.

 Rashtriya Swasthya Bima Yojana (RSBY)

Launched by Ministry of Labour and Employment, Rashtriya Swasthya Bima Yojana is government sponsored health insurance plan aimed at providing protection against financial liabilities arising due to health issues to those living below poverty line in India. The beneficiaries in the scheme are required to pay INR. 30 per year for renewal of the scheme.

Some of the other popular health insurance plans sponsored by the government of India include  Senior Citizen Health Insurance Scheme (SCHIS), Meghalaya Health Insurance Scheme (MHIS), and Deen Dayal Swasthya Seva Yojna (Goa).

 Strengthening of the primary care structure

Though the government of India has launched a number of health insurance schemes, the presence of sub-health centers across India has not been as effective as many would like. However, with the new schemes being rolled out by the government, they are being transformed into Health and Wellness Centers.

The scheme is funded not only by the center but also the state and has appointed well-trained mid-level health providers such as nurses, doctors, community health officers, and more.

This aims to deliver primary health care to all, across social strata and enabling a healthcare network that effectively and perpetually achieves.

This is extremely important in the Indian context because of the inadequate ratio of medical personnel to patients, and also due to the fact that private services have been dominating the sector due to simple quality reasons.

But what are these transformative aspects of the Indian Health Care system, and how are they impacting the sector?

Development and Investments

The healthcare sector in India has seen huge investments, especially in IT; post the requirement for telemedicine was recognized.

 The growth that the medicine and health-care industry witnessed in the last decade is almost outrageous, as it grew over 18% from 2010 to 2016.

The industry that was evaluated to be over 160 billion USD in 2016 is expected to reach 280 billion USD by the financial year 2020.

 This growth which comes with telemedicine, finances, all with profits and expenses are taken into account- is showing signs of improved medical supplies procurement in the sector.

This has resulted in decreasing expenses and costs of operation for hospitals and service providers while making health care more affordable for the patients.


The huge need in the sector was only waiting to be addressed with the coming up of telemedicine. It has transformed the way medicine sector radically.

Services like online doctor’s appointments and delivery of medicines are contributing greatly to the development of the healthcare sector.

 AI (Artificial Intelligence) driven services like virtual nurses, medics, and pharmacies have also played a major role to take a step ahead in this sector.

This has also enabled an improvement in the quality of offline services. Today the hospitals are able to give out information better and patients are able to utilize the transparency that comes with online systems.

Due to the ease of telemedicine, apps are being developed which remind people to drink water, track medicine cycles and courses, giving first aid help and more.

 Multinational companies, funding start-ups, and agencies are further working relentlessly to make the process of telehealth even easier.

The whole outcome is that the costs of medical assistance have gone down individually, and the process of diagnosis and aiding has been made much faster.

The convenience of Cloud

The streamlining of healthcare has become possible now that cloud services have taken over record keeping.

With texts and emails having replaced older modes of communication between the doctor and patient, it is only a matter of time until records found a digital home in cloud services. This has increased the ease of doctors and patients alike.

Hospitals access tracks better and the process of aiding medical assistance moves much faster and through a safer channel now that cloud services have taken over.

Artificial Intelligence in Hospitals

The functioning of hospitals has been transformed by the artificial intelligence. Now there are services that function seamlessly even in the direst of situations. 

Here are some ways hospitals have benefited from Artificial Intelligence.

 Data Computing

 Monotonous and laborious tasks like the entry of data are not only exhausting but also ridden with errors when done mechanically.

AI allows for these tasks to be done effectively with little to no room for error. Tasks which would be difficult and boring for human beings have been simplified hugely with AI.

Moreover, AI makes it very simple and quick to access medical records and history of patients, which in turn makes the process of medical assistance much faster.

Tests and Analysis

CT Scans, X-rays, and other testing procedures can be performed adequately and efficiently with the help of AI algorithms.

The results and analysis are also much faster with AI, especially in Cardiology and Radiology cases where a lot of data needs to be entered and processed.


The Artificial Intelligence systems being developed by some companies are so effective that they are working as well as experience-honed physicians.

Google has developed software which spots diabetic retinopathy as well as ophthalmologists only by accessing pictures. Moreover, a German research has enabled the same to happen in the field of dermatology as the newly developed AI can spot malignant melanomas, a primary symptom of skin cancer, with accuracy. 

AI is specializing to spot mutations in DNA as well as vascular diseases or cancers through scans.

Drug Creation

 Creating drugs is a task that requires a long time, sometimes even decades, and a lot of money, over millions of dollars.

 During the last outbreak of Ebola, AI enabled pharmaceuticals to assess existing drugs to see if they could be used for treatment.

It also simplified and fastened the processes of re-mastering medicines for the disease. This made it sufficiently clear that there is an excellent scope for AI taking over the Drug Creation sector.

What is Next?

If the Indian government can take the improving and developing technologies to imbibe them in the schemes and programs being introduced, the scope for their success enhances in a multi-fold manner.

It can help the government to catch up with their goal of an efficient and effective system of health care. Additionally, it can benefit a huge population that struggles with rising expenses of medical care.

 The system of Indian healthcare sure needs tweaking, and the fate of the new government schemes is much awaited. However, the scope of improvement that is offered by technological advancements is very wide and is going to continue offering room for more efficiency as time goes by.

First published: 18 August 2018, 18:07 IST