Only around 25% of the population has access to healthcare services in India

"Health Risk Factors in India" - a Swiss Re and Harvard T.H. Chan School of Public Health report

Swiss Re, the world's second largest reinsurer, launched a report titled 'Health Risk Factors - India in collaboration with the Harvard T.H. Chan School of Public Health. It highlights the considerable increase in incidents of non-communicable chronic diseases (NCDs) in India, including cardiovascular disease (CVD), making India a potential 'CVD capital' among the emerging markets. The research on the Systematic Explanatory Analyses of Risk factors affecting cardiovascular health (SEARCH) is conducted to better understand the relationship between risk factors and health outcomes, and build sustainable life and health insurance pools.

The Indian health insurance sector is a mix of mandatory social health insurance (SHI), voluntary private health insurance and community-based health insurance (CBHI). However, demand far outstrips supply. The result is queues, waits and scheduling at inconvenient times. The considerable underfunding of the public health services requires substantial numbers to parallel private health services. In urban areas, around 70% of households rely on the private sector as their primary health provider. The report highlights the potential positive impact insurance can have in supporting and financing improved health care solutions in the country.

According to Swiss Re's "Health Protection Gap[1]" study in 2012, even if healthcare expenditure remains a stable share of GDP, Indian health protection gap is projected to reach USD 43.6 billion by 2020. This is driven by (1) an ageing population (2) a wealthier society (3) health cost inflation driven by advances in medicine and (4) the growing consumer perception of insurance needs amongst other factors.

The Health Risk Factors in India report cites:

58% of healthcare spending is currently funded from out-of-pocket expenses.

NCDs currently account for 53% of the total deaths with projections indicating a further increase to 67% by 2030.

Projected increase of death due to NCDs will raise from 54% today to 67% by 2030.

About 2.7 million people die of CVD annually in India higher in absolute terms than China. This figure is projected to increase by 1.5 million by 2030.

Hypertension is the leading risk factor for CVD and accounts for nearly 10% of all deaths in India.

Diabetes is projected to increase to109 million diabetics by 2035.

CVD deaths in India are over 680 per 100'000 for men and 420 per 100'000 in women, which is twice those observed in the US.

Deaths from CVD in India will increase to 4.2 million people by 2030 and this will entail huge healthcare costs not only to individuals but also to the national economy.

Detloff Rump, Chief Underwriter Asia, Swiss Re, said Currently India is witnessing a transition period between the health conditions of developing and developed economies. By 2015, India's gross domestic product (GDP) is estimated to fall by 1% due to the combined economic impact of coronary heart disease, stroke and diabetes. This will impact not just the economy, but the insurers as well, since this disease is slowly becoming rampant.

Vivek Kuruvila, Head of Life & Health Client Markets, India, Swiss Re, added Swiss Re is collaborating with insurance companies to bridge the protection gap in India and fund healthier lives. The insurance industry is well equipped to meet the increasing demand for healthcare spending. There is also sustained interest in investing in the healthcare delivery model and on affordable primary care across India. This SEARCH report seeks to highlight health data and trends in the country that may make it easier for insurers to price, model and more widely distribute their products.

The aim of the collaboration is to better understand the relationship between risk factors and health outcomes in the major emerging markets of Brazil, China, India and Mexico. The health profile of these states is changing swiftly and significantly with economic growth. Incidents of NCDs are rising rapidly, providing a major challenge for public and private providers and funders of healthcare.

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