Rashtriya Swasthya Bima Yojana (RSBY) - Features & Implementation details

Rashtriya Swasthya Bima Yojana (RSBY) - Features & Implementation details

Question - Healthcare is one of the chief constituents of good governance. Discuss the Rashtriya Swasthya Bima Yojana which will now be implemented by the Ministry of Health and Family Welfare

Rashtriya Swasthya Bima Yojana/RSBY will now be implemented by the Ministry of Health and Family Welfare. It was earlier implemented by the Labour and Employment Ministry.

Features of RSBY

• RSBY is a health insurance scheme for below poverty line families

• It was launched for workers in the unorganised sector during the 2007-2008 fiscal

• It became fully operation with effect from April 1st, 2008

• This scheme provides for IT enabled and smart card bases chastens health insurance including maternity benefit of close to INR 30,000 per annum on a family floater basis to BPL families and 11 occupational groups in the organised sector

• The Unorganised Workers Social Security Act 2008 has come info force w.e.f 31st December 2008 and it covers 10 social security schemes benefiting workers in the unorganised sector including RSBY

• RSBY provides BPL families with freedom to choose between public and private hospitals

• The scheme is a good business model for all stakeholders and it has been designed as a business model for the social sector with incentives for every stakeholders; this model is ideal for sustaining and expanding the scheme at a later point in time

• Insurers are paid premiums for each household enrolled in the scheme and therefore have the motivation to enrol many households from the BPL list resulting in better coverage

• Hospitals have incentives to provide benefits to large number of persons as payment is made for each person treated; even public hospitals treat beneficiaries under RSBY as money from the insurer will flow to the required public hospital which can be used for their own purposes

• Intermediaries are also included; this comprises NGOs and MFIs as well who are paid for services offered to beneficiaries

• Government is able to provide adequate health care through payment of maximum sum of INR 750 per family leading to healthy competition between public and private sector healthcare providers

• IT apps are also being used in this scheme on a large scale; each BPL family os given a biometric enabled smart card with their photographs and fingerprints; RSBY is IT enabled and connected to servers at the district level to ensure smooth data flow for utilisation of services

• The scheme scores high on security as well through a key management system and use of biometric enabled smart card

• Another major feature of the scheme is its portability. Beneficiaries can use their smart card in any RSBY empanelled hospital in India. Cards can also be split for workers who move from one area to another in search of employment

• With cash-free and paperless transactions as well as robust monitoring and evaluation, RSBY is a scheme which uses technologies for delivering world class health care services

Facts and Stats

• RSBY has benefited 3,85,15,411 families in the period leading up to 31st March 2014.

• Around 10311 hospitals are providing services to insured persons; this includes 6093 private hospitals and 4218 governmental initiatives

• In this flagship scheme, insurance companies from the public as well as private sector are participating

• Centre’s share stands at INR 3738.05 crores and it was released during the past 6 years

• Release during the current fiscal is INR 548.40 up to 23rd March 2015

• From the 29 states and 7 UTs, the scheme did not operate in 3 states and 4 UTs

• It was operational for some time and stopped in 5 states and 1 UT

• In 21 states and 1 UT, the scheme is being continually implemented from FY 2008-2009

• 548 of the 676 districts have been covered under this scheme so far

• In India, from a total workforce of 47 crores, 8 crore work in the organised sector while 39 crore work in the unorganised sector

• RSBY was launched by the Labour and Employment Ministry to provide insurance
coverage

• Pre-existing conditions are covered under the scheme and there is no age limit

• Coverage extends to 5 members of the family including the head of the household, the spouse and three dependants

• Beneficiaries must pay INR 30 as fee while State and Central Governments pay the premium to the insurer