Rashtriya Swasthya Bima Yojana (RSBY)
Background and Scheme Objective
With a dramatic increase in population through the early years of this millennium, and a lack of corresponding growth in employment opportunities and wealth, it became evident that social security and healthcare for all was a pressing demand. According to reports from the early 2000’s, about 93 percent of the work force of the country was employed with the unorganized sector. While many of these workers were already below poverty line (BPL), the occurrence of ailments and hospitalization costs sapped the people of whatever little wealth they had. Despite widespread availability of medical facilities, quality healthcare costs in the country have remained high.
In order to address this concern, the government of India had enacted the Unorganized Workers Social Security Act in 2008. The act made it incumbent on the government of India to provide for the welfare of workers in the unorganized sectors. In an effort to compensate these workers for their out-of-pocket (OOP) health expenses, the government launched the Rashtriya Swasthya Bima Yojana (RSBY) in 2008. The RSBY is a health insurance scheme for families living below the poverty line.
The main objectives of the RSBY as outlined in the scheme website are as follows –
- To provide financial protection against catastrophic health costs by reducing OOP;
- To improve access to quality healthcare for below poverty line households of pocket expenditure for hospitalization and other vulnerable groups in the unorganized sector.
Scheme Rollout And Target Beneficiaries
The Rashtriya Swasthya Bima Yojana (RSBY) is a health insurance scheme that aims at providing health insurance coverage to the poor families of India. It provides cashless insurance coverage for hospitalization in both private and public hospitals. The cost of the insurance premium is borne by both the central (75 percent) and state (25 percent) governments. Initially, the scheme was launched by the Ministry of Labour and Employment, but was transferred to the Ministry of Health and Family Welfare on 1 April, 2015.
The RSBY was rolled out in 25 states of the country on 1 April, 2008. By February 2014, a total of 36 million families have been covered under the scheme.
The initial intention of the Rashtriya Swasthya Bima Yojna (RSBY) was to provide healthcare and financial relief only for those the Below Poverty Line (BPL). It later evolved, however, to cover other workers and their families not initially envisaged within the purview of the scheme –
These include –
- MNREGA workers who have been employed for over 15 days in the previous financial year
- Domestic helpers and workers
- Sanitation workers
- Miners and mine workers
- Rickshaw pullers and auto and taxi drivers
- Street vendors and railway porters
Details of the RSBY
According to the RSBY as launched in 2008 –
- Every BPL family holding a valid ration card may enrol to avail the insurance benefits as extended by the scheme;
- INR 30 will be charged as a one time registration fee;
- Upto 5 members of the family including one head of household, spouse and three dependent persons (children or parents) may be covered under the insurance scheme;
- Each family is entitled to claim (cashless) inpatient medical care up to INR 30,000 per annum;
- The hospitalization may be done in any of the empanelled hospitals;
- Pre existing ailments will be covered from Day 1 of the enrolment;
- Each family may also claim transport expenses of INR 100 per hospitalisation subject to a maximum of INR 1000 per family per annum.
Implementation Of The RSBY
According to the scheme schedule, the state government of each state is responsible for setting up up a State Nodal Agency (SNA), which shall, in turn, be responsible for implementing of the scheme. At a state level, the agency shall survey and make a list of the eligible families. These families shall then approach Mobile Enrollment Stations to submit photographs and biometric information (fingerprints) and collect the smart card at the same time.
The smart card not only proves the identity of the beneficiary, but also helps them avail cashless facilities at the hospitals. Complete scheme information and list of hospitals is provided by the SNA along with the smart cards. The Central Complaint and Grievance Redressal System (CGRS) handles the complaints received under the scheme and helps in resolving them.
In the 2012-13 Union Budget INR 1096.7 crore was allocated by the government towards RSBY. This was only a fraction of the amount required to cover the entire country’s BPL population and the scheme attracted much criticism.
Accolades And Appreciation
Despite falling short of covering the entire BPL population of the country, the excellent work done by the Rashtriya Swasthya Bima Yojna cannot be denied. According to recent news reports, the total number of hospitalisation recorded under the RSBY scheme amounted to about 11.8 million (as on 31 March, 2016).
The scheme and its outreach, the benefits imparted to millions of poor people in the country has attracted praises and accolades from international organizations such as the World Bank, the United Nations, and the International Labour Organisation. Germany has shown a keen interest in studying the smart card model with an intention to adopt it for its own social security schemes.
In furtherance with its own social security objectives, the NDA government has announced its intention to revamp the Rashtriya Swasthya Bima Yojna. Prime Minister Narendra Modi said that his government plans to increase the RSBY benefit from INR 30,000 per family per annum to INR 1 lakh per family per annum. This means a number of critical ailments could be covered by the benefits.
Currently, the average insurance claim per person under the scheme is INR 22,000 and an allocation of INR 1 lakh is a serious commitment on the government’s part.
The PM and his cabinet have also invited stakeholders and even members of the public to send in suggestions for increasing the coverage of the scheme and implementing it across the entire BPL population.
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