National Health Protection Scheme
Union budget 2018 announced a flagship National Health Protection Scheme to cover over ten crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to five lakh rupees per family per year for secondary and tertiary care hospitalisation.
Salient Features
Features of this policy Include:
- Rs 5 Lakh coverage per family for 10 crore families.
- Supporting the expansion of private players for better, efficient and targeted delivery of health services.
- Reducing of out of pocket expenditure for in-patients in secondary and tertiary health care.
- Greater inclusion of poor and marginalized sector of population who are concentrated in informal sector.
Feasibility
The feasibility of the scheme in ensuring of the stated objectives in question because:
- It doesn’t cover the out of pocket expenditure for out-patients which is a major burden for poor families.
- It doesn’t cover primary health care but rather focuses on secondary and tertiary health care.
- Scheme emphasizes on private sector rather than public sector for delivery of services.
Though NHPS has provision to overcome various lacunas of Rashtriya Swasthya Bima Yojana (RSBY), it falls short in achieving universalisation of Healthcare.
Role of States
Role of States in implementing the Scheme can be summarized as follows:
- National Health Policy (NHP) asks the States to raise their allocation for health to over 8% of the total State budget by 2020,
- Allocation of resources to fulfill the criteria of funding of the scheme which is in the ratio of 60:40 between Centre and States.
- NHPS will require a well-defined list of conditions that will be covered, diagnostic tests and treatments, cost and quality standards, and measuring health outcomes and cost-effectiveness. Central and State health agencies or their intermediaries will have to develop the capacity for competent purchasing of services from a diverse group of providers
- States must develop an institutional setup to implement the scheme either through the trust or an insurance company.
NHPS is a step forward. The ministries and the states need to evolve consensus on good design and reconfigure its budget allocations to ensure effective synchronization of all the policy strands. However, even before the scheme is launched, West Bengal has opted out of the scheme.
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National Health Protection Scheme
National Health Protection Scheme (NHPS) (Ayushman Bharat) is a proposed scheme of government of India, announced in Union Budget, 2018-19. The Scheme will provide health cover to more than 10 crore poor families. If an average family size is considered 5 members, the proposed scheme will have 50 crore people as beneficiaries. This mega health scheme will replace Rashtriya Swasthya Bima Yojana. NHPS is dubbed to be the world’s largest government funded healthcare programme.
Features of NHPS
- The scheme seeks to provide health cover to 10 crore economically vulnerable families.
- Every family will be provided Rs. 5 lakhs annually for secondary and tertiary health care.
- Rs. 2000 crore are allocated for the scheme in the budget 2018.
- The overall investment required for the scheme is estimated to be around Rs. 10,000 crores to Rs. 12,000 crores.
- The Premium for every household is expected to be Rs.1000 to Rs. 1200 annually.
- The scheme is a centrally sponsored scheme. The centre intends to bear 60 percent of the cost. Remaining 40 percent will be borne by the states.
- The scheme will replace Rashtriya Swasthya Bima Yojana under which, the government provided Rs.30,000 annually for healthcare. Under NHPS, Rs.30,000 is increased to Rs. 5 lakhs.
- The centre will face an annual burden of around Rs. 5000- 6000 crores towards premium. The rest will be come from state governments.
- NITI Aayog expects that at least 50% of the beneficiaries will use the scheme in the first year.
Modi-Care
The scheme is also being called Modi Care or Namo Care. Since health is a state subject, the states have welcomed the scheme and plan to launch it locally as soon as possible. The existing health cover programs of the different states will be subsumed into National Health Protection Scheme.
All the Public and empaneled private hospitals will implement the scheme. Rural hospitals will be encouraged to come under the scheme. The government also intends to provide incentives to improve the facilities of such rural hospitals. A strong IT structure will be put in place to avoid fraud and malpractices.
The launch of the scheme is planned for either August 15th 2018 or October 2nd 2018. The scheme will encourage economically weak sections to seek proper healthcare facilities without the fear of huge bills. The scheme will help India move towards better healthcare access and universal health coverage.
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