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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