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The Government’s flagship health insurance scheme for the poor has sharply reduced out-of-pocket expenditure in three States, says an evaluation by German enterprise GIZ and independent research body Prognosis Management & Research Consultants.
About 90 per cent of families enrolled in the Rashtriya Suraksha Bima Yojana (RSBY) said they did not have to pay a single paisa for hospitalisation, compared with Rs 17,000 a year spent by non-enrolled families, says the evaluation.
According to an estimate, India has the highest share of out-of-pocket expenditure in the world, at about 75 per cent, most of which goes into buying medicines.
The evaluation, done across 2,199 households in Vaishali district in Bihar, Udham Singh Nagar in Uttarakhand and Shimoga in Karnataka, also recorded a satisfaction rating of 90 per cent, with most people wanting to renew it.
In Uttarakhand, the health department played a key role in enrolling people, while in Karnataka the panchayat was a great enabler, it said.
Under the smart card-based health insurance scheme, coverage of Rs 30,000 is offered for a family of five. For this, a below poverty line (BPL) person has to pay Rs 30 a year to enrol, while 75 per cent of the premium is taken care of by the Centre and 25 per cent by the State.
However, the evaluation found that awareness about the scheme was still poor. “Information dissemination system needs to be strengthened a lot. As of now, word of mouth is the most popular communicator,” said a Prognosis researcher, while releasing the evaluation findings here on Monday.
Also, the Government needs to look at including out-patient benefits under RSBY, which forms a major part of a poor family’s medical expense.
The evaluation also suggested that more public hospitals be brought under RSBY in Bihar and Karnataka to improve access, and also underlined the need for a grievance redressal mechanism.
As of now, RSBY covers over 33.57 million families across States and has reported more than 4.68 million hospitalisation cases. About 12,000 hospitals are empanelled under the scheme, of which two-third are privately run. Of the 15 empanelled insurance companies, only four are Government–owned.
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