Publications of OECD (Organization for Economic Co-operation and Development) up to 2015 indicated that there are ~25 countries that have almost 100% health insurance cover for their populace. In the United States, this number is close to 85%. India is languishing at a paltry 17-20% number.
Of these, in most cases where we have 100% cover, government/social health insurance accounts for 100%. In the US government/social health insurance accounts for ~38% and in India that number is closer to 10%.
With income levels remaining either steady or declining and with healthcare costs rising India is facing a major crisis. Most healthcare expenses are paid out of pocket by patients and their families, rather than through insurance. This has led many households to incur Catastrophic Health Expenditure (CHE) which can be defined as health expenditure that threatens a household’s capacity to maintain a basic standard of living. One study found that over 35% of poor Indian households incur CHE and this reflects the detrimental state in which the Indian health care system is now.
So, either Indians (or for that matter anyone) avoid diseases or minimize the effects of disease by relying on tools that are readily available and consumable by all.
Key is to benchmark the current health and future health of the individual.
Once these two states are established accurately, it is all about managing the progression trajectory from current to future health.
One such example is presented above. An individual always has a choice to adhere to the current trajectory with zero intervention. However, if they seek Intervention 1 or 2 (depending on what is applicable for their health condition), they can change this trajectory. Trajectory 1 may allow them to avoid future hospitalization completely and just seek medical attention at a much later age. Trajectory 2 could be even better where they may not even require any further medical attention ever.
Providing proper tools to health managers and insurers that helps manage the individuals health trajectory.
If future health of an individual can be precisely predicted, small adjustments in personal health and attention to critical clinical parameters at the right time can make such trajectory changes possible. But the individual must know what exactly they need to do with proper targets and goals. Now with the advent of data analytics, predictive science, evidence based knowledge, all this is possible and we must arm our health managers and insurers with such tools. Only then will healthcare costs and affordability be manageable and the economic burdens of diseases not lead to CHE.