Health sector is the lifeline for a nation's wellbeing!
Rashtriya Swasthya Bima is a government-run health insurance scheme. It provides for cashless insurance for hospitalisation in public as well private hospitals. The scheme started enrolling on April 1, 2008 and has been implemented in 25 states of India. A total of 23 million families have been enrolled as of February 2011. The RSBY is a project under the Ministry of Labour and Employment.
Every "below poverty line" (BPL) family holding a yellow ration card pays 30 registration fee to get a biometric-enabled smart card containing their fingerprints and photographs. This enables them to receive inpatient medical care of up to 30,000 per family per year in any of the empanelled hospitals. Pre-existing illnesses are covered from day one, for head of household, spouse and up to three dependent children or parents.
The scheme is run on shared financial contribution by both central and state governments: 75% of the 600 premium (per person per year) is borne by the central government, and the rest by the state governments. There is profit motive for all parties involved. Private insurance companies provide the risk coverage, while private third-party administrators empanel hospitals and manage claims. Fixed rates have been prescribed for a long list of interventions.
The scheme is unique in the fact that it is heavily IT-enabled. Enrolment of families into the scheme, smart card generation, pre-authorization of admissions, as well as claim submission and approval, all occur electronically.
The workers in the unorganized sector constitute about 94% of the total workforce in the country. One of the major insecurities for these workers is the absence of health cover for such workers and their family members. Insecurity relating to absence of health cover, heavy expenditure on medical care and hospitalization and recourse to inadequate and incompetent treatment is not only a social and psychological burden borne by these workers but there are significant economic costs resulting from loss of earning and progressive deterioration of health. Thus, the Central Government came up with the scheme of providing health insurance coverage “RashtriyaSwasthyaBimaYojana” to BPL families.
Swathy was awarded with RSBY project for the states Gujarat, Maharashtra, Goa, Kerala, TamilNadu, Bihar, Karnataka and Haryana. The details of beneficiaries, their biometric data (finger prints and photograph) are taken and imprinted on the smart card chip.
We have provided personalized cards for 1.9 million BPL families. This is an ongoing project. So far, we have covered RSBY in 30 districts.