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LATEST NEWS UPDATES | Is the National Health Insurance Scheme in Chhattisgarh Doing More Damage Than Good? -Sulakshana Nandi

Is the National Health Insurance Scheme in Chhattisgarh Doing More Damage Than Good? -Sulakshana Nandi

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published Published on Nov 6, 2017   modified Modified on Nov 6, 2017
-TheWire.in

Studies from Chhattisgarh and other states show that most private hospitals force people to pay additional money even after using health insurance.

The Rashtriya Swasthya Bima Yojana (RSBY) or the National Health Insurance Scheme, was initiated in Chhattisgarh in 2009 for below poverty line (BPL) families. In 2012, Chhattisgarh expanded the scheme to non-BPL families as well, through the Mukhyamantri Swasthya Bima Yojana (MSBY), making it a universal scheme. Under the scheme, families need to pay a one-time fee of Rs 30 for getting an insurance card and the government pays the annual insurance premium for them. From October 1, 2017, Chhattisgarh government has increased the annual insurance entitlement for hospitalisation from Rs 30,000 to Rs 50,000, as promised in its 2013 election manifesto.

Chhattisgarh is seen as a ‘well performing’ state when it comes to the national health insurance scheme. The state has achieved enrolment of around 80% of the families by issuing 55 lakh cards, with insurance claims increasing every year. While the coverage and entitlements under the scheme are expanding, the cracks in its implementation are widening. There are serious concerns that the insurance scheme may be causing more damage to the state’s health than good.

People pay from their pockets even after using ‘cashless’ insurance

RSBY/MSBY is supposed to be ‘cashless’ insurance, i.e., people are to get completely free services in public or private hospitals empanelled under the scheme. Empanelled hospitals are not supposed to ask for extra money from patients as they agree to provide services at pre-designated package rates. But studies from Chhattisgarh and other states show that the health insurance is not ensuring cashless services. Most private hospitals force people to pay additional money even after using health insurance. The malpractice by private hospitals is so common that people have starting calling it a ‘discount’, rather than a ‘cashless’ card.

Our study in the slums of Raipur found that 96% women incurred expenditure for hospitalisation, regardless of card use. For those who used insurance, average additional expenditure from pocket was Rs 7530, while for the ones who did not use insurance, it was Rs 8624. Of those using insurance, the additional expenditure was four times higher in private (Rs 10,733) than in the public sector.

Please click here to read more.

TheWire.in, 3 November, 2017, https://thewire.in/193696/national-health-insurance-scheme-chhattisgarh-damage-good/


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