Swiss Re's SEARCH in India for healthy hearts

Only around 25% of the population have access to health-care services in India and we can do more to improve that.

India's output growth accelerated to 7.5% last quarter, putting it ahead of China as the world's fastest growing large economy. Although the country has seen the fastest annual growth since 2011, India stands on the verge of rapid shifts in health among the high growth markets and faces a big challenge with the high incidences of non-communicable diseases (NCDs).

Infectious diseases are still a serious public health concern and spread of NCDs is rapid. About 2.7 million people die of cardiovascular disease (CVD) annually and this number is projected to increase by 1.5 million by 2030, making India a potential 'CVD capital' among the emerging markets.

Highlighting the risk factors affecting cardiovascular health in India is the collaboration Swiss Re has with Harvard T.H. Chan School of Public Health, and other institutes including the World Health Organization, the Lown Institute and the Public Health Foundation of India through a research on the Systematic Explanatory Analyses of Risk Factors affecting Cardiovascular Health (SEARCH).

The SEARCH project is conducted to better understand the relationship between risk factors and health outcomes, and build sustainable life and health insurance pools. On 28 May 2015, renowned Indian and global experts, academicians from public health-care, (re)insurance and regulator came together to deliberate on the emerging CVD risks in India and its probable solutions. The event in Mumbai, based on the SEARCH findings in India, saw more than 80 participants from the insurance and health-care industry in India attending.

Three key areas of action emerged from various discussions during the day highlighting the role of the government, insurers and society, and each can do to support and finance improved health-care solutions, as well as support individuals to better manage their future health-care financing needs. The role of the government lies in strengthening of the public health-care systems. Without basic infrastructure in place, any attempt to bridge the funding gap for health-care would be futile. Government intervention is also required in effectively using fiscal instruments like taxation of tobacco products to reduce burden of cardiovascular risk factors. Dr. S(Subu) V Subramanian, Professor of Population Health and Geography at the Harvard T.H.Chan School of Public Health, brought forth the need for national surveillance data and appropriate resource allocation by policy makers in accordance with disease burden.

There is also a need for different insurance products that cover specific diseases, promote wellness and incentivize the buying of insurance by individuals. Clearly insurance products which focus on prevention and wellness (primary and secondary care) can address the problem to a greater extent that the current products which focus on treatment (tertiary care). In the common voice stood a contrarian view and with merit too; Dr. Nachiket Mor, Chair,CARE India, Member of the RBI Board, pointed out that the solution to this problem is not in insurance but lies in providing managed care through health-care providers where government should only play a facilitator.

Then there is the pertinent issue of creating awareness and education about diseases such as CVD, their current risk factors and the burden it is likely to put on India's economy. This is a task that the government, health-care providers and (re)insurers have to attain jointly as a society. Clearly the insurance industry can play a bigger role as pointed out by Ms.Yegnapriya Bharath, Joint Director of IRDAI. She shared that in the current scenario where health-care is not regulated, costs are prohibitive and as a result, the out-of-pocket expenses by individuals high there is a clear need for insurance to fund health-care.

I would like to share Vivek Kuruvila, Head of Life & Health Client Markets, SRSIPL (Swiss Re Services India Pvt. Ltd.) views - " We need to take a multi-pronged approach to address the problem namely sufficient investments in public systems, preventive incentives, a national repository of health data supporting investment decision making, shaping the role of insurance in the health-care space and innovative health insurance products that leveraged technology."

"There is a clear call to create conducive environment through right education, good health-care systems, effective use of fiscal instruments like taxation, close collaboration between health-care providers and insurance companies, and the right kind of products to address the cardiovascular risk factors and its impending economic burden. Let us each play our roles!

Here are some views from the participants we've invited to the event in Mumbai on 28May:

N Easwara, COO, Kotak General Insurance: “We look forward to more such events, so that you get a global view of things happening in the industry.India is plagued by lack of information and knowledge so I think more such events will be heavily appreciated”.

K U Bhaskar, Head Underwriting & Claims Cholamandalam MS: “Today’s exchange of views has really helped us understand how big the challenge is, I think we have now understood the gravity of the situation and I am glad that dialogues have started. It is a very good program in terms of sensitizing all the stakeholders”.

M Ravinder, ‎NationalHead, Tata AIG General Insurance Company Ltd: "This is very useful for the insurance industry to design their products we as part of Tata AIG will be very keen to take this forward in terms of designing our products. A very well organized forum."

Nikhil Gupta, Appointed Actuary,Oriental Insurance: "It is an eye-opening study and a great initiative by Swiss Re. Swiss Re provided a great platform to interact with various stake-holders."

Puja Parekh, Health-care Consultant, Reliance Foundation:"It is a wonderful initiative where these organizations have come together to lead the way for something that will affect us in 10 years."

Press coverage in Business Standard and The Economic Times.

Summary by Shivani Sarwal. This article is based on Cardiovascular health risk factors in India, which took place in Mumbai on 28 May 2015.