More than two years after it was first envisioned, the Union Health Ministry has sent a concept note to the Prime Minister’s Office on universal health coverage (now called health assurance).
The partly insurance-based scheme that borrows from Central Government Health Scheme, Rashtriya Swasthya Bima Yojana and the Andhra Pradesh government’s Arogyashri scheme has five major components — preventive and promotive healthcare, free drugs, free diagnostics, admission in government hospitals or referral to private providers and tertiary care. The per person annual expense, as per the report of the high-level committee set up by the Ministry under Dr Ranjit Roychowdhury, comes to Rs 600 for primary healthcare, an additional Rs 400 for secondary healthcare and Rs 150 more for tertiary care.
In the concept note, the Ministry has mooted the formation of a trust, like in Arogyashri, that will process treatment expenses with the government paying the full premium amount for the poor and a part of it for people who are better off. Affluent sections who do not want to opt for private insurance will have the option of enrolling with the trust against payment of the full premium amount.
The income ceilings will have to be worked out and the total cost of the scheme — if it is approved by Prime Minister Narendra Modi in its proposed format — will depend on that figure. The per capita cost calculations made by the Roychowdhury committee are still being debated within the Ministry, sources said.