Karnataka government's Swasthya Bima Yojana to operate as a standalone scheme till August

BENGALURU: Rashtriya Swasthya Bima Yojana, with around 62,06,620 Below Poverty Line (BPL) families enrolled in Karnataka (third highest in the country), which provides a medical insurance of up to Rs 30,000 for a family of five — defined as the ability to spend Rs 33 per day in urban India and Rs 27 per day in rural areas — is being renamed as the National Health Protection Scheme (NHPS) which is being merged with the state’s Arogya Karnataka.

The Centre’s NHPS operates on an insurance model where insurance companies will function as an intermediary between the beneficiaries and the government, and take care of empanelment of hospitals and payment of premiums. Whereas the state’s Arogya Karnataka is built on a trust model, wherein, the Suvarna Arogya Suraksha Trust does the management of finances on behalf of the government.

Despite this fundamental difference, the government is merging the two and till modalities are worked out, RSBY will continue as a standalone scheme till August-end, according to a government order issued late on Saturday.  Till NHPS is rolled out in the state, all private hospitals currently empanelled will get provisional empanelment for the co-branded scheme.

Commenting on the development, Akhila Vasan, convenor, Karnataka Janarogya Chaluvali, said, “Since the two schemes operate on different models, this GO will buy more time for the government to work out the modalities. But will they issue more RSBY cards? Will the beneficiaries expand? What happens to the cards once it becomes NHPS? Will they use Arogya Karnataka cards or NHPS cards? Currently, we are using the ration card or Aadhaar card as identification. But the government shouldn’t waste public money issuing new cards.”

Since RSBY is restricted to hospitalisation expenses as an in-patient, it hasn’t reduced any out of pocket expenditure for the poor, a study published in Social Science and Medicine Journal in March last year, concluded.The study titled, ‘Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out-of-pocket spending for healthcare’, was conducted by Anup Karan of the Public

Health Foundation of India along with others. Since the poor have to forego wages to get hospitalised, they preferred outpatient treatment that RSBY does not cover.The study observed, “The likelihood of incurring any out-of-pocket spending (inpatient and outpatient) rose by 30% due to RSBY and was statistically significant.”Now when the NHPS is merged with Arogya Karnataka, it will provide a larger cover of Rs 5 lakh per family of five, but since it will operate just like RSBY did with a lesser coverage, whether it will benefit the poor is yet to be seen.