This paper discusses how the failure of the public and the private healthcare systems has affected the poor. It also tries to explore the possibility of a financial mechanism like insurance and how it can bring about (from experiences drawn from other countries) the much needed health systems reform. This overall theme is known as the Health ecosystem Concept. This concept visualizes public health system beyond the realm of preventive/promotive care and explores newer avenues for Public-Private Partnership for curative care. In this document, insurance is visualized as not only paying for the curative care of the community but also tries to overcome the systemic errors in the current set up by improving infrastructure, providing incentives for man power and bringing about overall accountability into the system. It also suggests the use of technology to integrate and bring about efficiency in the entire health system and generate essential data in the process for evidence based action.