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Even as experts are seeking clarity in the health care plan announced by Prime Minister Narendra Modi on Monday, it is likely the Rs 1-lakh payout towards health care costs for poor families will come from a combination of schemes run by states and the Centre’s Rashtriya Swasthya Bima Yojana (RSBY).
While the RSBY is a family floater insurance scheme, some of the state schemes are run by trusts. None of these is direct payment to patients. The new scheme, too, will either be an insurance scheme or one run by a trust or society, analysts pointed out.
RSBY offers up to Rs 30,000 for health care costs for poor families and covers both government and private hospitals. Both central and state governments pay the premium towards RSBY. As on March 31, 2016, the total number of hospitalisation under RSBY was 11.8 million. “If the government wants to increase the amount to Rs 1 lakh, then it is likely that critical illness, too, may be brought under it. The fact that the PM has announced it shows the government’s determination to carry out the scheme,” said Sanjay Dutta, head of underwriting, claims and reinsurance, ICICI Lombard General Insurance. Nishant Berlia from the PhD Chamber of Commerce believes with the Aadhar and the BPL card holders list, disbursing this money will be easy. He welcomes the amount the government is setting aside for the treatment of the poor.
The average insurance claim per person is Rs 22,000, Berlia said. “In this scenario, putting aside Rs 1 lakh per family is a good amount.”
Welcoming the announcement, S Prakash, executive director, Star Health, said that one challenge in implementing the health care scheme is the lack of standardisation in health care practices and cost of consumables. “When a massive scheme is run across the country, the implementing authority should have knowledge of health care practices as well as insurance. Standardisation in procedures and cost is critical.”
