Evaluation of Scheme Done by Council for Social Development:

  • RSBY had little or no impact on medical impoverishment in India
  • Despite high enrolment in RSBY scheme, catastrophic health expenditure, hospitalisation expenditure, out of pocket expenses – medicine, food etc. that are not reimbursed by insurance have steadily increased , for both in and out-patient, over the last two decades.
  • Scheme has largely not able to provide financial risk protection
  • Study points out that major flaw in design of RSBY is that it has a narrow focus on secondary and tertiary care hospitalisation
  • Study points that: scheme is largely used by those who had better access to healthcare services and the most marginalised sections were being excluded
Write a critical note on the objectives, design and implementation of the Rashtriya Swasthya Bima Yojana (RSBY) programme. (200 Words)
Rashtriya Swasthya Bima Yojana (RSBY) was launched by Ministry of Labour and Employment, Government of India in 2008 to provide health insurance cover to Below Poverty Line population and informal sector workers of India.
Its objective is to protect these families from shocks related to catastrophic expenditures on health by improving access to health and reducing out of pocket expenditure.
  • This is a Smart Card based cashless and paperless social health insurance scheme.
  • It provides annual hospitalization cover up to Rs. 30,000 for a family of five members through health insurance companies.
  • Families pay only a registration fee of Rs. 30 and get a RSBY smart card which helps in accessing empaneled hospitals across the country for in-patient treatment.
  • Transportation expenses up to Rs. 1,000 per year are provided in cash for travelling to the hospital.
  • All pre-existing diseases are covered from day one. There is no age limit to enrol in the scheme.
  • 75 % of the cost (premium) of the scheme is borne by Central Government (90% in case of Jammu & Kashmir and North-Eastern States) and the rest is borne out by respective State government.
There have been some problems with its design and implementation. The poor in the more remote blocks and villages may be ignored for easier to reach potential enrolees as the premium paid for all are the same.
Empaneled hospitals tend to be placed near district headquarters, raising costs of access for the poor beyond that covered in the programme and packages do not recognise treatment and care uncertainties that incentivise hospitals to treat simpler and less complicated diseases. Additionally, a lack of adequate planning for change in insurance providers creates breaks in service that are avoidable.



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