Rashtriya Swasthya Bima Yojana (RSBY) for Universal Health Coverage

Pawan Kumar Taneja and Shallini Taneja

Asian Journal of Management Cases, 2016, vol. 13, issue 2, 108-124

Abstract: On 10 June 2012, Anil Swarup, Additional Secretary, Ministry of Labour & Employment, Government of India (GOI), reviewed the report submitted to the Planning Commission of India by High Level Expert Group (HLEG) on universal health coverage (UHC) for India; 1 he had mixed feelings about this report. It (HLEG) reported that the main impeding factor to UHC in India is the heavy out-of-pocket (OOP) expenditure on health, that is, 61.7 per cent of the total health expenditure by Indians as compared to the global average of 20.5 per cent. Looking for a solution for this problem, the report appreciated his brainchild, the Rashtriya Swasthya Bima Yojana (RSBY), a social health insurance scheme rolled out in 2008 to reduce OOP expenditures for healthcare. The scheme also aimed to cut down a substantial financial burden on the poor by the GOI. The RSBY scheme was lauded for its innovative approach in financing mechanism, 2 public private partnership (PPP) model for enrolment process, use of information and communication technology for delivery of healthcare services. However, the report questioned the potential of RSBY to achieve UHC due to issues in its sustainability. The scheme faced challenges of low coverage ratio, unfair practices in enrolment and hospitalization processes in many parts of the country, inconsistent usage patterns of services, and backing out by insurance companies as result of high claims ratio. 3 Swarup was in a dilemma of how to address these issues and make RSBY a platform to implement universal health coverage (prime area of concern for GOI) in India.

Keywords: Universal health coverage; health insurance; business model; public private partnership; social health insurance; Rashtriya Swasthya Bima Yojana (RSBY); innovation management (search for similar items in EconPapers)
Date: 2016
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Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:anjomc:v:13:y:2016:i:2:p:108-124

DOI: 10.1177/0972820116653335

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