India has set ambitious targets for developing its healthcare sector. One recent estimate suggests that the country’s universal healthcare rollout may cost up to $26 billion over the next four years—more than the government’s current annual spending on all facets of healthcare. Improving health services will be a question of not just providing new financing, but of increasing access to medical care and fostering innovation that can address the country’s complex challenges. How can India meet its goal to provide healthcare for all?

With this question in mind, NBR spoke with Anup Malani (University of Chicago Law School and Pritzker School of Medicine). In this interview, Professor Malani offers insights into efforts to strengthen India’s healthcare sector and discusses how U.S.-India collaboration can facilitate the innovation needed to achieve the Modi administration’s ambitious targets. He argues that while there is no single solution for addressing the country’s healthcare challenges, collaborative efforts that engage a range of stakeholders will play a key role in moving forward.

You are working on a large project that assesses India’s healthcare sector and addresses how to enlarge the population covered by health insurance. What are the goals of this project?

The project is called the Indian Health Insurance Experiment. I lead a team of researchers in three countries who are conducting a large-scale, randomized control trial to assess the benefits and costs of using India’s existing Medicaid-like public health insurance plan—known as the Rashtriya Swasthya Bima Yojana (RSBY)—as a platform for universal coverage. This has suddenly become very relevant because the new Modi administration has identified universal coverage as a policy priority. The study examines the merits of different approaches to ensuring that every household has financial access to necessary healthcare, with an eye toward the impact of universal coverage on the Indian government’s budget. To ensure it is representative, the study includes nearly 60,000 subjects and over two hundred towns and villages in central and southern India. We are collaborating with the Indian government to make sure that the study provides actionable evidence on reforming healthcare financing policy.

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