We have drawn learnings from our field surveys and interactions with practitioners, experts and grassroots organizations working in the field of healthcare. Our key learnings with respect to healthcare supply are on four main segments; doctors, diagnostics, drugs and hospitals
Service Providers
- Primary care is mostly provided by local “doctors” – quacks, ex-compounder apart from BAMS and BHMS
- Doctor availability varies across different regions, e.g. 1 in 4 villages in some regions of Maharashtra vs 1 in 1 Block in some regions in Gujarat
- Doctors do recognize that they have spare capacity and are keen to increase patient flow
Diagnostics
- Diagnostic laboratories available at town levels
- Diagnostic laboratories pay upto 30% as commission to doctors
- Diagnostic laboratories willing to give 30%+ discounts for volumes
Drugs
- Drugs form ~80% of outpatient care costs
- High Drug cost a serious concern for consumers
- Pharmacy typically available close to doctors
- Most commonly used drugs cost 25-30% to manufacture and another 10-15% to deliver to the retailer level
Hospitals
- Multi-specialty hospitals available at nearest town levels, which consumers are comfortable with
- Hospitals have spare capacity and keen to increase patient
The Indian healthcare system focusing at quality today services the high-income segments but has not reached out to the low-income segments. This is because of three key issues with respect to health insurance
Accessibility
- Lack of access to information
- Complex administrative procedures give bad reputation
- At times lack of access to basic health care services
Affordability
- High costs of outpatient care, particularly drugs
- High one time premium for the entire family / true insurance
- Buffers for adverse selection, fraud, etc. increase the
Acceptability:
- Lack of understanding of insurance as a concept
- Complex product design with too many exceptions / clauses
- Limited perceived health benefit since insurance benefit limited to hospitalization only, which has only 2-3% incidence, while there is no benefit on outpatient care which has > 100% incidence
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