Imagine living with knee pain so severe that climbing a single flight of stairs feels like scaling a mountain. This was the daily reality of a patient treated by Dr. Mahesh Kulkarni, Consultant, Joint Replacement Surgeon at Deenanath Mangeshkar Hospital, for several years.
Limited mobility had gradually taken over his life until he underwent a robotic-arm assisted joint replacement. The transformation was remarkable. Not only did he regain the ability to walk pain-free, but months later, he went on to complete a high-altitude multi-day trek.
“When I first met him, he could barely move,” recalled Dr Kulkarni. “After the robotic procedure, his recovery was far quicker than expected. Seeing him trek at high altitudes was extraordinary. This is what advanced technology makes possible. Robotic surgery isn’t a luxury. It’s how people reclaim their lives,” he added.
The widening gap between technology and access
In India, nearly 60 million people live with arthritis, yet fewer than 10% undergo joint replacement surgery1. Many delay treatment until they are nearly immobile, losing productive years to pain and disability.
Today, the debate is no longer about whether joint replacement works; it is a well-established, highly successful procedure. The real issue is access. While advanced robotic-assisted surgery is available, many patients are unable to benefit from it because health insurance policies have not evolved in step with medical innovation.
Why robotic surgery is a game-changer
Globally, robotic-assisted joint replacement is rapidly becoming the standard of care. In countries such as the US and Australia2, it is widely adopted because of its clear clinical advantages.
These include:
Given these advantages, the question arises: if the technology exists, surgeons are trained, and outcomes are demonstrably better, why aren’t more Indian patients accessing robotic surgery?
The insurance bottleneck
A major barrier lies in health insurance policies. Even when robotic surgery is clinically recommended, many policies impose ‘sub-limits’ on advanced procedures. These caps force patients to opt for conventional surgery over robotic-assisted options, purely for financial reasons, even when the latter could enable faster recovery and earlier return to work.
“I often have to explain to patients that the surgery I truly believe offers them the best outcome isn’t fully covered by their insurance,” said Dr. Havind Tandon, Senior Consultant, Orthopaedics and Joint Replacement, Apollo Hospital, adding, “These are not people seeking premium experiences. They are working individuals who have saved for years to afford treatment. When insurance policies don’t reflect modern medical practice, patients pay the price - in pain, mobility, and years of their lives.”
A win-win opportunity
Expanding insurance coverage for robotic surgery isn’t just beneficial for patients, it also makes financial sense for insurers.
Toward a fairer system
Health policy experts argue that aligning insurance coverage with medical advancement can create a virtuous cycle. As Aman Gupta, Asia Representative at the Partnership to Fight Chronic Disease (PFCD), notes, “Markets that treat robotic surgery on par with conventional procedures see better outcomes, fewer complications, and lower long-term claims. This isn’t a choice between better care and financial sustainability. The evidence shows they go hand in hand.”
To move forward, insurers should:
Should a patient’s ability to walk without pain depend on fine print in an insurance document? As medicine advances, insurance frameworks must evolve alongside it. When doctors, technology, and insurers work in alignment, robotic surgery stops being perceived as a ‘premium’ option and becomes what it truly is - better, smarter healthcare for all.
References:
Limited mobility had gradually taken over his life until he underwent a robotic-arm assisted joint replacement. The transformation was remarkable. Not only did he regain the ability to walk pain-free, but months later, he went on to complete a high-altitude multi-day trek.
“When I first met him, he could barely move,” recalled Dr Kulkarni. “After the robotic procedure, his recovery was far quicker than expected. Seeing him trek at high altitudes was extraordinary. This is what advanced technology makes possible. Robotic surgery isn’t a luxury. It’s how people reclaim their lives,” he added.
The widening gap between technology and access
In India, nearly 60 million people live with arthritis, yet fewer than 10% undergo joint replacement surgery1. Many delay treatment until they are nearly immobile, losing productive years to pain and disability.
Today, the debate is no longer about whether joint replacement works; it is a well-established, highly successful procedure. The real issue is access. While advanced robotic-assisted surgery is available, many patients are unable to benefit from it because health insurance policies have not evolved in step with medical innovation.
Why robotic surgery is a game-changer
Globally, robotic-assisted joint replacement is rapidly becoming the standard of care. In countries such as the US and Australia2, it is widely adopted because of its clear clinical advantages.
These include:
- Greater precision: Robotic systems enable highly accurate planning and placement of implants.
- Faster recovery: Patients often experience reduced pain, shorter hospital stays, and quicker rehabilitation.
- Lower risk of revision surgery: Precision reduces implant failure, minimising the need for repeat operations that are costly and physically taxing.
Given these advantages, the question arises: if the technology exists, surgeons are trained, and outcomes are demonstrably better, why aren’t more Indian patients accessing robotic surgery?
The insurance bottleneck
A major barrier lies in health insurance policies. Even when robotic surgery is clinically recommended, many policies impose ‘sub-limits’ on advanced procedures. These caps force patients to opt for conventional surgery over robotic-assisted options, purely for financial reasons, even when the latter could enable faster recovery and earlier return to work.
“I often have to explain to patients that the surgery I truly believe offers them the best outcome isn’t fully covered by their insurance,” said Dr. Havind Tandon, Senior Consultant, Orthopaedics and Joint Replacement, Apollo Hospital, adding, “These are not people seeking premium experiences. They are working individuals who have saved for years to afford treatment. When insurance policies don’t reflect modern medical practice, patients pay the price - in pain, mobility, and years of their lives.”
A win-win opportunity
Expanding insurance coverage for robotic surgery isn’t just beneficial for patients, it also makes financial sense for insurers.
- Fewer complications translate to lower follow-up costs
- Reduced revision surgeries lead to significant long-term savings
Toward a fairer system
Health policy experts argue that aligning insurance coverage with medical advancement can create a virtuous cycle. As Aman Gupta, Asia Representative at the Partnership to Fight Chronic Disease (PFCD), notes, “Markets that treat robotic surgery on par with conventional procedures see better outcomes, fewer complications, and lower long-term claims. This isn’t a choice between better care and financial sustainability. The evidence shows they go hand in hand.”
To move forward, insurers should:
- Eliminate sub-limits specific to robotic-assisted procedures
- Treat robotic and traditional joint replacement equally in policy terms
- Streamline approvals for clinically recommended modern treatments
Should a patient’s ability to walk without pain depend on fine print in an insurance document? As medicine advances, insurance frameworks must evolve alongside it. When doctors, technology, and insurers work in alignment, robotic surgery stops being perceived as a ‘premium’ option and becomes what it truly is - better, smarter healthcare for all.
References:
- https://www.sciencedirect.com/science/article/pii/S1063458422007427
- https://www.jbjs.org/reader.php?rsuite_id=7d84c9ab-a526-4468-b1b5-ccfae2cb05da&source=JBJS_Open_Access/9/3/e24.00063&topics=kn#info
- https://aoanjrr.sahmri.com/documents/d/guest/aoa-full-report-2025
(This article is generated and published by ET Spotlight team. You can get in touch with them on etspotlight@timesinternet.in)
