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Resource centre on India's rural distress
 
 

Jaitley is Carrying Forward a Deeply Flawed Health Insurance Program -Subhashish Bhadra

-TheWire.in

The message coming out of finance minister Arun Jaitley’s budget this year is that the rural economy is back at the heart of policy-making. One of the highlights of the budget was the announcement of the ‘Health Protection Scheme’, under which poor households will be provided with an annual cover of Rs. 1 lakh to protect them from health-related financial shocks. This marks a significant expansion of the Rashtriya Swasthya Bima Yojana, under which the cover was limited to Rs. 30,000. While the move has generated mostly positive responses, it is a matter of concern that a program whose efficacy is shrouded in mystery is being expanded. This becomes all the more worrisome when one takes into account that the infrastructure-augmenting National Rural Health Mission (NRHM) has seen no such increase in outlay.

Unlike the NREGA, publicly available information on the RSBY programme is rare. This has seriously hampered academic work that can evaluate the impact of the program. Yet, a few researchers have managed to study the impact of the RSBY and similar state-level schemes. While evidence of a reduction in financial burden for households is unambiguous, that on the quality and accessibility of hospitals is mixed.  What that implies is that households are merely saving cash that they would have earlier spent on healthcare, and the scheme has failed to increase access to quality healthcare. If this is the case, then a direct cash transfer would work better. A direct cash transfer would also help in getting rid of the perverse incentives that the RSBY creates for hospitals; the mass hysterectomies identified in Bihar are a prime example of these incentives

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