The Ministry of Health is preparing to roll out an expanded version of the Rashtriya Swasthya Bima Yojana, the government’s flagship health insurance scheme, covering more than 10 crore families or about 50 crore people.
The plans come a year after the health ministry got the administrative responsibility for RSBY from the Ministry of Labour, which launched it in 2008. The expanded scheme will be the first step towards universal health insurance, though the final modalities and the name of the scheme are still a work in progress.
Beneficiaries will be listed not just on the basis of income — as is the criteria for BPL families — but also based on “deprivations” as listed in the socio-economic caste census, so that a little more than the total BPL families are covered. The actual rollout will be done by states which will, therefore, have a say in the final basket of services to be covered and also the ceiling for a particular procedure covered under the scheme.
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The health ministry is also looking at developing an IT platform where health-related schemes not just of this ministry but also those of other ministries that have a bearing on health — for example, the Janani Shishu Suraksha Yojana of the Women and Child Development Ministry — can be managed from the same platform and a common registration system, ensuring there is neither duplication nor wastage of resources.
When it was transferred to Health from Labour, RSBY came with about 3.72 crore active smart cards, which would entail coverage for about 15 crore people from BPL families. It was transferred as the NDA government felt universal insurance is key to the concept of health assurance as visualised in lieu of what was earlier known as universal health coverage.
Instead of starting from scratch it was decided that RSBY, which is an internationally feted insurance-based health scheme, should be restructured and expanded. Launched in 2008, RSBY provides health cover to BPL households with beneficiaries entitled to hospitalisation cover of Rs 30,000 for a range of diseases. Pre-existing conditions too are covered.
“We are looking at an IT-supported implementation platform for this insurance scheme — whether it will continue to be called RSBY or may be renamed is not clear yet — but this platform will be one where schemes of all ministries including ours can be mounted for effective implementation. We are still in the process of working out what schemes will be covered and what would be the ceiling for individual procedures. States can add to both by paying for the additional coverage. There will also be a very important element of screening for diabetes, hypertension and some common cancers to begin with,” said a senior official in the ministry of health.
Sources in the health ministry say the restructured RSBY, possibly under a new name, is likely to be rolled out by the financial year 2017-18. Initially the idea was to shift to a trust-based model but after health experts and some states red-flagged that idea, the ministry is now looking at a more open-ended scheme with states having the power to decide whether it should be through a trust or in partnership with insurance companies.