In the era of growing healthcare expenditures, health insurance has become essential for all families. A significant portion of Indians remain still far from the advantages, despite the government’s introduction of healthcare programs like Ayushman Bharat and reasonably priced generic medications through Jan Aushadhi Kendras. The poor receive treatment at the lowest possible cost under Ayushman Bharat. Given the nation’s escalating healthcare expenditures, it is definitely time for taxpayers to be taken into account for the benefits.
For the first time in our nation, health insurance companies are requesting a 10%–15% premium rise for New Delhi residents due to an increase in respiratory illnesses and other health issues brought on by or made worse by poor air quality, as well as claims associated with these issues. Pollution in the region is not caused by a single factor, but a combination of elements – such as construction activities, vehicular emissions, industrial pollutants and the seasonal burning of crop residue.
The potential of an economic disaster is also there in the insurers’ request to raise health costs in New Delhi because of ailments linked to pollution. The idea almost amounts to a criminal insult added to a harm caused by the state. Insurance firms use the usual risk assessment model as the basis for their argument, which states that greater hospitalisation rates ought to result in higher insurance premiums.
Delhi may be the first Indian city to see a direct link between air pollution and health insurance rates if insurance companies are able to obtain Insurance Regulatory and Development Authority of India (IRDAI) certification for pollution-based pricing. This action would also pave the way for premium hikes in other major cities with serious air quality problems, such as Ghaziabad, Gurgaon, Noida, Hisar, Muzaffarpur, Jalandhar, etc., and may make quality healthcare coverage more expensive and unaffordable for many residents who need it most.
If the proposal is passed, many people who need health insurance the most will probably no longer be able to pay it. The financial burden on policyholders has already increased due to the 18 percent GST on health and life insurance premiums, and the GST Council did not provide any tax relief at its December meeting. Many residents could find it more difficult to afford high-quality health insurance if premiums increase.
Senior citizens, children, outdoor workers, and those with underlying respiratory disorders could be disproportionately affected because they would probably pay the highest rates. In order to put such a reform into effect, insurers must first provide IRDAI with proof that there is a direct link between higher health insurance claims and toxic air.
The insurers’ plan presents significant ethical issues in addition to adding to people’s financial burdens. They provide the standard risk assessment claim that increased hospitalisation rates should lead to higher insurance costs. Although this reasoning is sound, it ignores a fundamental ethical issue: air pollution is a systemic issue rather than a personal choice.
Unlike unhealthy lifestyle choices like smoking, which may have an impact on insurance prices, pollution is an unavoidable external factor. Penalising residents who have no control over the air they breathe shifts accountability from the companies and governments that produce pollution to the people who are only attempting to live in a more poisonous environment.
Pollution in Delhi is not caused by a single factor but a combination of elements, such as construction activities, vehicular emissions, industrial pollutants, and the seasonal burning of crop residue in states like Punjab, Haryana, and Uttar Pradesh. Stubble burning contributes to air pollution, especially during winters.
A two-member bench of Justices Arun Mishra and Deepak Gupta has warned that state governments will have to pay damages if they do not provide clean air and water to citizens. They blame state governments for not addressing the problem and declared that living without pollution is a constitutional right.
Since the policymakers and industries are responsible for the environmental pollution causing illnesses in people who are merely trying to survive in an increasingly toxic environment, making people pay more premiums is not the answer. The policymakers should identify the root cause/s for the pollution and initiate corrective measures by alleviating the root cause.
The basic goal of health insurance, which is to provide financial stability against unanticipated medical emergencies, would be compromised if systemic environmental problems were to influence prices. Insurers need to look at other options rather than charging policyholders for services.
(The Author is Deputy Director of Boilers (Retd) Government of Karnataka. Feedback: [email protected])
