{"id":31224,"date":"2018-10-27T12:36:07","date_gmt":"2018-10-27T07:06:07","guid":{"rendered":"https:\/\/blog.forumias.com\/?p=31224"},"modified":"2018-10-27T12:36:07","modified_gmt":"2018-10-27T07:06:07","slug":"not-a-prescription-for-the-poor","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/not-a-prescription-for-the-poor\/","title":{"rendered":"Not a prescription for the poor"},"content":{"rendered":"<p><a href=\"http:\/\/www.thehindu.com\/todays-paper\/tp-opinion\/not-a-prescription-for-the-poor\/article22779517.ece\"><b>Not a prescription for the poor<\/b><\/a><\/p>\n<p><b>Context:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The National Health Protection Scheme (NHPS) is being hailed as the biggest takeaway for the aam aadmi in this year\u2019s Budget.<\/span><\/li>\n<\/ul>\n<p><b>Problems:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The Budget promised to provide insurance coverage to an estimated 50 crore poor beneficiaries through the NHPS. There are two problems with this claim.<\/span><\/li>\n<\/ul>\n<p><b>Old scheme:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">1-<\/span><span style=\"font-weight: 400;\"> \u00a0<\/span> <b>Rashtriya Swasthya Bima Yojana<\/b><span style=\"font-weight: 400;\"> (RSBY) :<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">It was launched in 2008 \u00a0to target only the Below Poverty Line (BPL) households.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">However, even after nine years of its implementation, only half the BPL families have been covered, according to government data.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">There is a huge discrepancy between the coverage figures in government data and estimates from surveys.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">In the 71st round of the National Sample Survey (NSS), 11.1% of the population was covered by the RSBY and State health insurance schemes in 2014 but according to the Insurance Regulatory and Development Authority, the population coverage of these schemes was 16.4%.<\/span><\/li>\n<\/ul>\n<p><b>Key reasons for such discrepancy:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The creation of bogus beneficiaries by insurance companies to earn premium subsidies from the government.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Insurance companies have been given the premium subsidy for covering all eligible households in the respective States, the insurer reached out to only a fraction of the eligible population.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">For example, in 2016, only 2.45% eligible families were enrolled under Maharashtra\u2019s Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) in 2016.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Enrolment was also found to be very low in the Chief Minister\u2019s Comprehensive Health Insurance Scheme, in Tamil Nadu, as shown in the NSS data.<\/span><\/li>\n<\/ul>\n<p><b>2-<\/b><span style=\"font-weight: 400;\"> \u00a0\u00a0\u00a0\u00a0\u00a0<\/span><b>Identification of poor households.<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">According to the NSS data for 2014, among the poorest quintile, 12.7% of households received RSBY coverage, which accounted for 25.9% of all the RSBY enrolled households.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">About 36.52% of households enrolled in the RSBY were actually drawn from the richest 40% of the sample households.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Almost half the households enrolled in the RSBY actually belonged to the non-poor category.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The targeting process in RSBY has been fraught with exclusion errors.<\/span><\/li>\n<\/ul>\n<p><b>Access issues<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">According to the programme data, the hospitalisation rate was found to be as low as 1% among RSBY-insured individuals, compared to a national average of 2.6% for the general population as of 2014.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The utilisation rate of other insurance schemes is also very low.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">For example, the MJPJAY recorded a utilisation rate (calculated as the proportion of eligible persons with at least one in-patient claim during the year) of just 0.12% in 2013-14 and 0.18% in 2014-15.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Two very recent impact evaluation studies have reported that the RSBY has hardly had any impact on financial protection.<\/span><\/li>\n<\/ul>\n<p><b>There are two reasons:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">International experience in publicly funded health insurance in unregulated private health-care markets. This mean a larger transfer of public money into private hands.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">In absence of strong and effective government regulations for insurers and providers, well-recognised market failures such as supplier-induced demand will ensure that eligible families exhaust full coverage with little improvement in their well-being.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Not a prescription for the poor Context: The National Health Protection Scheme (NHPS) is being hailed as the biggest takeaway for the aam aadmi in this year\u2019s Budget. Problems: The Budget promised to provide insurance coverage to an estimated 50 crore poor beneficiaries through the NHPS. There are two problems with this claim. Old scheme:&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/not-a-prescription-for-the-poor\/\">Continue reading <span class=\"screen-reader-text\">Not a prescription for the poor<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[555],"tags":[],"class_list":["post-31224","post","type-post","status-publish","format-standard","hentry","category-test-1","entry"],"jetpack_featured_media_url":"","views":{"total":0,"cached_at":"","cached_date":1704909231},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/31224","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=31224"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/31224\/revisions"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=31224"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=31224"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=31224"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}