Rashtriya Swasthya Bima Yojana

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Rashtriya Swasthya Bima Yojana (RSBY)
RSBY Logo.jpg
CountryIndia
Prime Minister(s) Dr. Manmohan Singh
Launched1 April 2008;16 years ago (2008-04-01)
StatusActive

Rashtriya Swasthya Bima Yojana (RSBY, literally "National Health Insurance Programme", [1] ) is a government-run health insurance programme for the Indian poor. The scheme aims to provide health insurance coverage to the unrecognised sector workers belonging to the BPL category and their family members shall be beneficiaries under this scheme. [2] It provides for cashless insurance for hospitalisation in public as well as private hospitals. The scheme started enrolling on April 1, 2008 and has been implemented in 25 states of India. [3] A total of 36 million families have been enrolled as of February 2014. [4] Initially, RSBY was a project under the Ministry of Labour and Employment. Now it has been transferred to Ministry of Health and Family Welfare from April 1, 2015 [5]

Every "below poverty line" (BPL) family holding a yellow ration card pays 30 (38¢ US) registration fee to get a biometric-enabled smart card containing their fingerprints and photographs. [1] This enables them to receive inpatient medical care of up to 30,000 (US$380) per family per year in any of the empanelled hospitals. Pre-existing illnesses are covered from day one, for head of household, spouse and up to three dependent children or parents. [3]

In the Union Budget for 2012–13, the government made a total allocation of 1,096.7 crore (US$140 million) towards RSBY. Although meant to cover the entire BPL population, (about 37.2 per cent of the total Indian population according to the Tendulkar committee estimates) it had enrolled only around 10 per cent of the Indian population by March 31, 2011. Also, it is expected to cost the exchequer at least 3,350 crore (US$420 million) a year to cover the entire BPL population. [6]

The scheme has won plaudits from the World Bank, the UN and the ILO as one of the world's best health insurance schemes. Germany has shown interest in adopting the smart card based model for revamping its own social security system, the oldest in the world, by replacing its current, expensive, system of voucher based benefits for 2.5 million children. [7] The Indo-German Social Security Programme, created as part of a co-operation pact between the two countries is guiding this collaboration. [8] [7]

One of the big changes that this scheme entails is bringing investments to unserved areas. Most private investments in healthcare in India have been focused on tertiary or specialized care in urban areas. However, with RSBY coming in, the scenario is changing. New age companies like Glocal Healthcare Systems, a company based out of Kolkata and funded by Tier I Capital Funds like Sequoia Capital and Elevar Equity are setting up State of Art Hospitals in Semi Urban - rural settings. This trend can create the infrastructure that India's healthcare system desperately needs. [9]

As per report from Council for Social Development, it was found that this scheme has not been very effective. Increase in outpatient expenditure, hospitalization and medicines have compelled insurance companies to exclude several diseases out of their policies and thus making it not affordable for BPL families. [10] Report also has found that most of the beneficiaries are from higher classes and not targeted beneficiaries.

Ayushman Bharat - Pradhan Mantri Jan Aarogya Yojana (PMJAY) is proposed to subsume RSBY and provide an insurance cover of 0.5 million (US$6,300) each to 10 crore families. [11]

See also

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  1. Substantial expansion and strengthening of public sector health care system, freeing the vulnerable population from dependence on high cost and often unreachable private sector health care system.
  2. Health sector expenditure by central government and state government, both plan and non-plan, will have to be substantially increased by the twelfth five-year plan. It was increased from 0.94 per cent of GDP in tenth plan to 1.04 per cent in eleventh plan. The provision of clean drinking water and sanitation as one of the principal factors in control of diseases is well established from the history of industrialized countries and it should have high priority in health related resource allocation. The expenditure on health should increased to 2.5 per cent of GDP by the end of Twelfth Five Year Plan.
  3. Financial and managerial system will be redesigned to ensure efficient utilization of available resources and achieve better health outcome. Coordinated delivery of services within and across sectors, delegation matched with accountability, fostering a spirit of innovation are some of the measures proposed.
  4. Increasing the cooperation between private and public sector health care providers to achieve health goals. This will include contracting in of services for gap filling, and various forms of effectively regulated and managed Public-Private Partnership, while also ensuring that there is no compromise in terms of standards of delivery and that the incentive structure does not undermine health care objectives.
  5. The present Rashtriya Swasthya Bima Yojana (RSBY) which provides cash less in-patient treatment through an insurance based system should be reformed to enable access to a continuum of comprehensive primary, secondary and tertiary care. In twelfth plan period entire Below Poverty Line (BPL) population will be covered through RSBY scheme. In planning health care structure for the future, it is desirable to move from a 'fee-for-service' mechanism, to address the issue of fragmentation of services that works to the detriment of preventive and primary care and also to reduce the scope of fraud and induced demand.
  6. In order to increase the availability of skilled human resources, a large expansion of medical schools, nursing colleges, and so on, is therefore necessary and public sector medical schools must play a major role in the process. Special effort will be made to expand medical education in states which are under-served. In addition, a massive effort will be made to recruit and train paramedical and community level health workers.
  7. The multiplicity of Central sector or Centrally Sponsored Schemes has constrained the flexibility of states to make need based plans or deploy their resources in the most efficient manner. The way forward is to focus on strengthening the pillars of the health system, so that it can prevent, detect and manage each of the unique challenges that different parts of the country face.
  8. A series of prescription drugs reforms, promotion of essential, generic medicine and making these universally available free of cost to all patients in public facilities as a part of the Essential Health Package will be a priority.
  9. Effective regulation in medical practice, public health, food and drugs is essential to safeguard people against risks and unethical practices. This is especially so given the information gaps in the health sector which make it difficult for individual to make reasoned choices.
  10. The health system in the Twelfth Plan will continue to have a mix of public and private service providers. The public sector health services need to be strengthened to deliver both public health related and clinical services. The public and private sectors also need to coordinate for the delivery of a continuum of care. A strong regulatory system would supervise the quality of services delivered. Standard treatment guidelines should form the basis of clinical care across public and private sectors, with the adequate monitoring by the regulatory bodies to improve the quality and control the cost of care,

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References

  1. 1 2 Jackie Range. "India's poor get healthcare in a card". Wall Street Journal. Retrieved 26 February 2011.
  2. "Rashtriya Swasthya Bima Yojana | India Portal". india.gov.in. Retrieved 11 August 2016.
  3. 1 2 "About RSBY". Ministry of Labour and Employment. Retrieved 26 February 2011.
  4. "Rashtriya Swasthya Bima Yojana".
  5. "RSBY:National Summary". Ministry of Labour and Employment. Retrieved 26 February 2011.
  6. "Healthy outlook in Budget". The Hindu BusinessLine. 22 March 2012.
  7. 1 2 Dr. Saumitra Mohan (15 May 2017). "10.7 - Rashtriya Swasthya Bima Yojana (RSBY)". Indian policy and development. McGraw-Hill Education. p. 72. ISBN   9789352606740 . Retrieved 3 January 2020., Citation: Currently revamped RSMY covers three crore workers...RSBY will be responsible for providing secondary healthcare benefits also.'.
  8. "German delegation visiting India to take Rashtriya Swasthya Bima Yojana lessons". The Economic Times. 6 August 2012.
  9. "Rural India looking for high quality healthcare". The Economic Times. 3 February 2012.
  10. "Poor risk cover". The Hindu .
  11. "Less than half of budgeted allocation for Modicare released: Parl panel report", Hindustan Times , 13 March 2018