As Healthcare Affordability Returns to Parliament, Jose Peter of Arogya Finance on the Financing Gap Beyond Insurance

Insurance is an essential part of healthcare protection. However, it is designed around defined risks, conditions and coverage limits. The actual financial journey of a patient is often more complicated. Treatment may involve exclusions, waiting periods, co-payments, non-covered medicines, medical devices, diagnostics or procedures that fall outside the policy. Many families may also have no insurance or insufficient coverage for the treatment being recommended.

This creates a financing gap between the cost of care and the amount immediately available to the patient.

When Treatment Cannot Wait

Healthcare expenses are different from most household purchases. A family can postpone buying a vehicle or renovating a home, but an angioplasty, cancer therapy, cochlear implant or urgent surgery may not offer the same flexibility. The decision must often be made within hours or days, even when the required money is unavailable.

In such circumstances, families commonly depend on savings, informal borrowing, the sale of assets or high-cost credit. Some delay treatment, choose a less suitable option or discontinue therapy midway. Affordability, therefore, does not merely determine how a bill is paid. It can influence whether treatment begins at all.

The missing layer is purpose-built healthcare financing that is accessible at the point of care and structured around the treatment journey.

Financing Should Complement Insurance

Medical financing should not be viewed as a substitute for insurance. The two serve different but complementary purposes. Insurance protects against covered healthcare risks, while financing can help bridge the immediate shortfall when coverage is absent, partial or delayed.

This is particularly relevant for elective treatments, advanced therapies, recurring medicines, diagnostic procedures and medical devices. It can also support insured patients awaiting reimbursement, enabling them to proceed with treatment without placing the entire interim burden on their households.

For this system to work responsibly, financing must be transparent, appropriately assessed and suited to the patient’s repayment capacity. Speed is important in healthcare, but it cannot come at the expense of responsible lending.

Building Finance Around the Patient

Technology has made it possible to assess applications, complete digital verification and disburse medical loans far more quickly than traditional lending processes allowed. However, technology is only part of the solution. Healthcare financing also requires coordination among hospitals, pharmaceutical companies, medical-device manufacturers, insurers and lenders.

At Arogya Finance, we have seen how financing embedded at the point of care can reduce friction for patients. Our model combines digital assessment with healthcare partnerships to offer no-cost or low-cost EMI options, depending on the programme. The objective is to make appropriate treatment financially reachable, including for people who may remain outside conventional lending systems.

The Next Affordability Conversation

India needs wider insurance coverage, stronger public healthcare, greater price transparency and continued action on medical inflation. Alongside these priorities, healthcare financing deserves recognition as part of the country’s affordability infrastructure.

The question before policymakers should not only be how many people are insured. It should also be what happens when insurance does not cover the complete cost, when reimbursement takes time or when a family must pay before treatment can begin.

Closing that gap will require insurance and financing to work together. Healthcare becomes meaningfully accessible only when the availability of treatment is matched by a practical and responsible way to pay for it.