Why UPI Succeeded and Health ID Struggles: The Power of One Referee

 When we talk about India’s digital success stories, UPI (Unified Payments Interface) always comes up first.

But when we shift to healthcare, the same smooth experience is still missing. Your health records are scattered across hospitals, labs, and clinics. Why is it so much harder to build a “UPI of healthcare”?

One big reason: the role of a single regulator.

🏦 Banking: One Referee, One Rulebook

UPI worked because the banking system had one clear authority: the RBI (Reserve Bank of India), which gave NPCI (National Payments Corporation of India) the job of building UPI.

That meant:

• All banks had to play by the same rules.

• No bank could say, “We’ll build our own separate system.”

• Interoperability was not optional — it was mandatory.

 

🏏 Real-Life Example: Cricket with One Umpire

Think of a cricket match. If there is one umpire for both teams, the game runs smoothly. Everyone trusts the same decisions.

But imagine if each team brought its own umpire. One says “Out!”, the other says “Not Out!” Chaos, arguments, and no real game.

UPI avoided this chaos because RBI + NPCI acted like the single umpire for all banks.

📲 How It Works in Your Daily Life

• You use Google Pay (your app).

• Your friend uses PhonePe (another app).

• Your bank is ICICI, their bank is SBI.

Even with four different players involved, money flows instantly. Why? Because everyone follows one framework — UPI — enforced by one regulator.

🏥 Healthcare: Too Many Umpires, Too Many Rulebooks

Now, let’s look at healthcare.

• One hospital stores patient data in Excel sheets.

• Another scans everything as PDFs.

• A third uses its own proprietary hospital software.

There is no single regulator forcing everyone to adopt the same format. Hospitals set their own rules, and systems don’t talk to each other.

The result? Patients carry files, repeat tests, and face delays in emergencies.

🔑 The Takeaway

UPI succeeded because:

• One regulator (RBI) created a single rulebook (UPI).

• All players had to comply.

• Interoperability was built-in, not optional.

Healthcare struggles because:

• There are many regulators and bodies.

• Hospitals have little incentive to share data.

• There’s no strong enforcement of interoperability.

🚀 What Healthcare Can Learn from UPI

For Health ID (ABHA ID) and FHIR to succeed, India’s healthcare system needs:

1. A strong central authority (like RBI for banks).

2. A single enforced standard (like UPI for money).

3. Clear incentives for hospitals to adopt and share data.

✅ Closing Thought

"UPI worked because there was one umpire, one rulebook, and one game. Healthcare still feels like a match with too many umpires and no agreed rules. For Health ID to succeed, we need the same discipline that made UPI a household name."

💬 Do you agree? Should India push for a single strong regulator for health data, just like RBI for banking?

#DigitalHealth #UPI #FHIR #ABDM #HealthcareInnovation #PatientEmpowerment #HealthTech