In general terms, insurance is a contract whereby the insurance company pays compensation to its policyholders or their kin in case of occurrence of any eventuality mentioned in the insurance contract in consideration for the receipt of a premium. Insurance covers diverse subjects like a person's life, health, wealth etc. Health as a subject of insurance has emerged as one of the most important topics both in the health and insurance sectors these days. Many developed and developing countries use health insurance as a public health financing plan. Health insurance in fact has been an important tool for achieving the public welfare objective of a state. Both the insurance and health domains have multifaceted characteristics with public-centric nature. There are chances of coherence between these two sectors with mutual leveraging effect as well as some level of synergy. The concept of insurance seems to be younger than the concept of healthcare. Whereas the concept of social health plan is one of the late-emerged ideas packaged with two verticals of health and insurance together. This amalgamation concept emerged to cater to the need of social developments, rising health facility cost and increasing public awareness towards a healthy life. When it comes to healthcare, the sector in itself is a multi-disciplinary one with a big ecosystem including versatility of stakeholders requiring multiple regulators. Probably, the health domain is the only sector having multiples of regulators for any single domain. Let’s think of aviation as one of the bigger industries where there is only one regulator. Likewise, the financial sector, which is equally or even more crucial and larger, has got only one regulatory body. The area which we are talking about—insurance—is also having a single regulator.

This whole ground of discussion is reflecting the size and wider dynamics of the health sector. Against this backdrop, the question arises: “Can we fit insurance into health or does health deserve to accept insurance?” The shortest answer is yes. The length of the answer can be stretched up to making a series of books.

Many a time, we are pinched and pricked by a common question regarding the above-mentioned importance of insurance in the healthcare domain. Then why is Nepal not practicing health insurance in full-swing? Per se, Nepal is one of the Low Middle Income Countries (LMICs). By default, we will be able to taste the development later than any other developed country. Nevertheless, we have been practicing it for a long time in the case of road traffic accidents, providing health services to foreigners and some range of employee health benefits. It won’t be an overstatement to point that Nepal is now leapfrogging in this matter directly from the phase of crawling, something we were observing till four or five years back. Thanks to the government for introducing a national health insurance plan and including a health component in the Social Security Fund. Insurance pundits differ on this matter and they are not ready to accept these two big plans as an insurance scheme. In their viewpoint, this does not get reinsurance protection and it is including pre-existing disease conditions too with disregard to underwriting and other technical procedures. They take these two schemes as social schemes. The ambivalence and dilemma in this incorporation are in the fundamentals of these two domains. Health is regarded as a social domain whereas insurance is regarded as a financial and profit-oriented business. Despite this difference, there are enough grounds that these two sectors can be adhered to support each other, to thrive together and finally to keep end-users i.e. the general public in a more beneficial position. The basis of a golden handshake that these two domains can have are: They both are public-oriented businesses, both of them follow the theory of ‘beneficence’ and ‘non-maleficence’ and they both follow strict protocols. The healthcare industry, being a full-population touching industry, can provide a strong ride to the insurance sector in helping its expansion and increasing level of acceptance. Insurance, on the other hand, can support and promote the health sector in making it more responsible, more protocol-centric and well-documented. On top of that, they can synergize in introducing digitization showing fingers to each other, which ultimately benefits every stakeholder.  Last but not the least, they can create enhanced skills in the employee and introduce another area of service like a third-party administrator (TPA). Thus, insurance and health should be blended as two separate engines or better say co-rotator wheels. For getting this done, a series of workouts are required in the form of smart-work rather than in the form of hard-work. This is the call of all three ‘C’s, namely citizens, community and country. The writer is a CEO at Reliance Life Insurance