Names of some public and private health care systems in India
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India has a universal multi-payer health care model that is paid for by a combination of public and private health insurance funds along with the element of almost entirely tax-funded public hospitals.[1] The public hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some services.[2] At the federal level, a national publicly funded health insurance program was launched in 2018 by the Government of India, called Ayushman Bharat. This aimed to cover the bottom 50% (500 million people) of the country's population working in the unorganized sector (enterprises having less than 10 employees) and offers them free treatment at both public and private hospitals.[1] For people working in the organized sector (enterprises with more than 10 employees) and earning a monthly salary of up to ₹21,000 are covered by the social insurance scheme of Employees' State Insurance which entirely funds their healthcare (along with unemployment benefits), both in public and private hospitals.[3][4] People earning more than that amount are provided health insurance coverage by their employers through either one of the four main public health insurance funds which are the National Insurance Company, The Oriental Insurance Company, United India Insurance Company and New India Assurance or a private insurance provider. As of 2020, 300 million Indians are covered by insurance bought from one of the public or private insurance companies by their employers as group or individual plans.[5] Indian nationals and expatriates who work in the public sector are eligible for a comprehensive package of benefits including, both public and private health, preventive, diagnostic, and curative services and pharmaceuticals with very few exclusions and no cost sharing. Most services including state of the art cardio-vascular procedures, organ transplants, and cancer treatments (including bone marrow transplants) are covered.[6] Employers are responsible for paying for an extensive package of services for private sector expatriates (through one of the public or private funds) unless they are eligible for the Employees' State Insurance. Unemployed people without coverage are covered by the various state funding schemes for emergency hospitalization if they do not have the means to pay for it.[7] In 2019, the total net government spending on healthcare was $36 billion or 1.23% of its GDP.[8] Since the country's independence, the public hospital system has been entirely funded through general taxation.