NEW DELHI: The Centre is considering to revise the proposed National Health Protection Scheme for providing health insurance benefit of about Rs 3 lakh to about 50 per cent population in the country making it the biggest ever public sector health insurance plan in the country.
The scheme, earlier planned with Rs 1 lakh benefit for those covered, was first announced by Prime Minister Narendra Modi in his independence day in 2016. The modified scheme is likely to be incorporated in 2018-19 union budget, top sources in the Union health and Family Welfare ministry told this newspaper.
A senior official in the ministry said that the scheme had already obtained the approval from Expenditure Finance Committee of the finance ministry but a decision to enhance the insurance amount and include new clauses were taken later.
“Under the scheme, an additional top-up package of Rs. 30,000 will likely be provided to senior citizens. The scheme is estimated to cost Rs. 24,000 Crores to the government for 5 years and will go further up if the benefit of additional two lakhs is added,” the official familiar with the development said.
The scheme is projected to benefit about 10 Crore families in the first phase. The main beneficiaries of the scheme would be the families belonging to the Below Poverty Line category or those in the list of deprivations as per the socio-economic caste census data.
Currently named as NHPS, the scheme may get a new name upon the launch next year.
The Centre, in 2008 had launched Rashtriya Swasthya Bima Yojana, with health cover up to 30,000 but the enrolment for the scheme has been poor in most states.
Some studies done to see the impact made by the scheme, so far, also show that most families covered under the scheme continue to incur catastrophic health expenditure due to hospitalisation due to low amount of coverage granted under RSBY.
Sources meanwhile said that under the new scheme, as the number of hospitals added to the empanelled network will increase including primary, secondary and tertiary care hospitals, it will potentially improve overall healthcare in the country.
At present, there are about 18,000 hospitals that cater to patients cover under the RSBY.
“We are also trying to fix rates decided for various medical procedures scientifically. The current rate fixed for reimbursement is very low and not arrived scientifically,” the official conceded. “So hospitals are either reluctant to be a part of the scheme or cut corners to compensate for that loss. Either way, it is the common man who is affected.”
He further added, “To improve efficiency of the scheme, the option of co-payment can also be included as that will empower and help patients. This will be beneficial for middle-class families who cannot afford the entire treatment but can pay a little more to the hospital for advanced care.”