National Health Protection Mission

Context:

• The National Health Protection Scheme (NHPS), recently announced by the Centre in Budget 2018, has been seen a potential to become the centerpiece to achieve universal health coverage, once a few implementation issues are resolved.

National Health Protection Mission is a part of Ayushman Bharat yojana which has two major health sector initiatives:

Health and Wellness Centre:  

• These Centres will provide Comprehensive health care.
• It will be responsible for providing free essential Drug and diagnostics Services.

National Health Protection Mission:

• NHPM will subsume the on-going centrally sponsored schemes -RashtriyaSwasthyaBimaYojana (RSBY) and the Senior Citizen Health Insurance Scheme.

Salient Feature National Health Protection Mission:

• National Health Protection Mission will have a defined benefit cover of Rs. 5 lakh per family per year.
• Benefit will be allowed to take cashless benefits from any public/private empanelled hospitals across the country.
• National Health Protection Mission will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the SECC database.
• The beneficiaries can avail benefits in both public and empanelled private facilities.
• To control costs, the payments for treatment will be done on package rate (to be defined by the Government in advance) basis.
• One of the core principles of National Health Protection Mission is to co-operative federalism and flexibility to states.
• For giving policy directions and fostering coordination between Centre and States, it is proposed to set up National Health Protection Mission Council (AB-NHPMC) at apex level Chaired by Union Health and Family Welfare Minister.
• States would need to have State Health Agency (SHA) to implement the scheme.
• In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction.

Implementation strategy:

• The States/ UTs would be advised to implement the scheme by a dedicated entity called State Health Agency (SHA).
• They can either use an existing Trust/ Society/ Not for Profit Company/ State Nodal Agency (SNA) or set up a new entity to implement the scheme.
• States/ UTs can decide to implement the scheme through an insurance company or directly through the Trust/ Society or use an integrated model
• 60 percent of the cost will be borne by the Centre and the remaining 40 percent will be incurred by the states.
• Funding of the Scheme is likely to come from the additional 1% health cess announced in the union budget.
• The government intends to provide family cards with unique QR codes to the scheme’s beneficiaries.

Note: The World Health Organization (WHO) hailed India’s National Health Protection Scheme (NHPS), an ambitious plan to provide health insurance to 50 crore people.

Major Impact of National Health Protection Mission:

• National Health Protection Mission will have major impact on reduction of health expenditure on common people.
• It will Increase benefit cover to nearly 40% of the population, (the poorest & the vulnerable).
• It will cover almost all secondary and many tertiary hospitalizations.
• It will provide coverage of 5 lakh for each family.
• This will lead to increased access to quality health and medication.

National Health Protection Mission will further benefits the section of society by:

• Providing timely treatments, improvements in health outcomes;
• Patient satisfaction;
• Improvement in productivity and efficiency; and
• Job creation thus leading to improvement in quality of life.

Challenges in implementing the programme:

• Lack of education, gender inequality and explosive growth of population contribute to increasing burden of disease;
• Expenditure on health by the Government continues to be low. ( As per National health Accounts – the total health expenditure is 4.02% of GDP for 2013-14);
• States government under financial constraints cut expenditure on health.
• Illiteracy, Lack of information, women’s education;
• Public policies cutting across sectors;
• Reluctance of people to bear the cost for benefits to others;
• Poor standards of Government facilities; and
• Medical and healthcare related scams.

Way forward

• Strengthening of primary healthcare, provision of free drugs and diagnostics at public health facilities, and stepping up financial protection for healthcare through a government-funded programme, the scheme proposes to improve improved access to healthcare.
• Identify true beneficiaries for the scheme is a major challenges for government.
• India needs to do a lot more on infant mortality and unequal access to medical care.
• Good Health and Well-Being for people Goal 3 is one of major goals Sustainable development goals (SDGs) which will need serious strategy to implement and make it a success.