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RSBY will be restructured to widen the coverage
Oct 12, 2015

Rashtriya Swasth Bhima Yojana (RSBY) will be restructured to make its coverage wider, intensive, flexible and IT driven. The restructured scheme to be coordinated by the Union Health Ministry will bring together the disjointed schemes coordinated by different agencies under one umbrella.    The new scheme is likely to be operational shortly.

Giving details of the proposed restructured RSBY at the 9th Health Insurance Summit organized by Confederation of Indian Industry (CII) in the capital today, Mr Bhanu Pratap Sharma, Secretary, Health, Ministry of Health and Family Welfare,  said that the new scheme would have more benefits and beneficiaries.  MOUs would be entered with the state governments. Those States which want to extend the services to people above poverty line (APL) and provide secondary and tertiary benefits could do so as a top up of the scheme. 

An important feature of the new scheme, Mr Sharma said was the strong IT platform which would be created for facilitating the operations of the scheme. A large database is being created that would detail facilities at every hospitals, disease profile and other details and would help immensely every stakeholder.  

Mr Sharma informed that the restructured RSBY would  cover around 8 to 10 crore BPL people   and there will be enhancement of cash limits for treatment.  Improved quality, universal coverage, affordability would be the hall mark of the new scheme, which will also lay stress on preventive medical care.  In this regard, he said that the scheme envisages free medical check-ups once in every three years for the age group vulnerable  to cardiac diseases and diabetes.

The Health Secretary stressed that the private-public partnership (PPP) model would be used for creating strong infrastructure in the health landscape. This is possible through a   good contract management framework, where aspirations and responsibilities of the stakeholders are addressed to.  Some of the reputed NGOs could also be brought into the health insurance sector by having such systems in place. About the availability of medical personnel, the Health Secretary assured that legislation should be passed in the near future for augmenting the supply of quality personnel, such as doctors, para-medical staff.  And barefoot doctors, There is also a proposal to speed up the process of accredition of hospitals.

Regarding the regulatory framework, Mr Sharma said that Centre has enacted the Clinical Establishment Act which has to be adopted by the State Government.  So far, 14 or 15 State Governments have adopted it and the rest are considering it though there are some differences of opinion, which he hoped would be resolved at the earliest.

Mr G Srinivasan, CMD, New India Assurance Co Ltd, in his special address, stressed the need for insurance companies coming out with simple products to gain acceptance of the customers. Warning that India has become a disease and accident capital of the world, he called for   urgent steps for promoting insurance products in the country. Vast majority of the people are outside the purview of health insurance, which he opined should need urgent attention. He laid emphasis on   quality, accessibility and affordability, which should become corner stone of the health policy.    Standardization, digitization coupled with high awareness could enhance the insurance penetration in the country.

Dr Naresh Trehan, Chairman, CII National Council on Healthcare, in his address, said, “We have a lot of reservoir of knowledge technology and human capital in the private sector. This along with predetermined realistic costs can be used to our advantage to plug the gaps that may exist today in healthcare delivery”.

Mr A Vaidheesh, Chairman, CII Sub-Committee on Accessibility and Health Insurance, said that health insurance is critical for the middle class. They are the backbone of the country.  “We need insurance products that suit them.  One health episode in the family destroys their aspirations”, he added.

Mr Rahul Khosla, Co-chairman, CII Healthcare Council and MD, Max India Ltd, has stressed the need for streamlining the payments to RSBY. He also wanted building up of trust among the players through regular consultations among the stakeholders to sort out their differences and build mutual trust.

New Delhi
12th October 2015

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