Is RSBY India’s platform to implementing universal hospital insurance.
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Date
2012-01
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Abstract
Background & objectives: In 2008, India’s Labour Ministry launched a hospital insurance scheme called
Rashtriya Swasthya Bima Yojana (RSBY) covering ‘Below Poverty Line’ (BPL) households. RSBY is
implemented through insurance companies; premiums are subsidized by Union and States governments
(75 : 25%). We examined RSBY’s enrolment of BPL, costs vs. budgets and policy ramifications.
Methods: Numbers of BPL are obtained by following criteria of two committees appointed for this task.
District-specific premiums are weighted to obtain national average premiums. Using the BPL estimates
and national premiums, we calculated overall expected costs of full roll-out of the RSBY per annum, and
compared it to Union government budget allocations.
Results: By March 31, 2011, RSBY enrolled about 27.8 per cent of the number of BPL households following
the Tendulkar Committee estimates (37.6% following the Lakdawala Committee criteria). The average
national weighted premium was ` 530 per household per year in 2011. The expected cost of premium to
the union government of enrolling the entire BPL population in financial year (FY) 2010-11 would be
` 33.5 billion using Tendulkar count of BPL (or ` 24.6 billion following Lakdawala count), representing
about 0.3 per cent (or 0.2%, respectively) of the total union budget. The RSBY budget allocation for FY
2010-11 was only about 0.037 per cent of the total union budget, sufficient to pay premiums of only 34
per cent of the BPL households enrolled by March 31, 2011.
Interpretation & conclusions: RSBY could be the platform for universal health insurance when (i) the budget
allocation will match the required funds for maintenance and expansion of the scheme; (ii) the scheme would
ensure that beneficiaries’ rights are legally anchored; and (iii) RSBY would attract large numbers of premiumpaying
(non-BPL) households.
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Keywords
Below-poverty-line, Health insurance, Healthcare, India, non-BPL, RSBY
Citation
Dror David M, Vellakkal Sukumar. Is RSBY India’s platform to implementing universal hospital insurance. Indian Journal of Medical Research. 2012 Jan; 135(1): 56-63.