Department of Community Medicine JN Medical College AMU, Aligarh TEAM JNMC
RASHTRIYA SWASTHYA BIMA YOJANA (RSBY) –HEALTH INSURANCE FOR POOR
Before 11th fiveyear plan healthinsurance wasonly available to Only 16% population government covered employeesorganised sectorprivate health insurance RSBY started rolling from 1st April 2008.
WHAT IS RSBY ‘cash-less’ smart card based health insurance cover of Rs 30,000 per annum each enrolled family, comprisin g up to five individuals.
BENEFICIARIESOriginally limited to Below Poverty Line (BPL) familiesbuilding and other construction workers, MGNREGA beneficiaries, street vendors, beedi workers, and domestic workers. Registration/renewal fee – Rs 30/annum per family Premium – centre and state in 75:25 ratio.
INSURERS HOSPITALS INTERMEDIARIES GOVERNMENT BUSINESS MODEL FOR ALL STAKE HOLDERS INFORMATION SAFE AND TECHNOLOGY INTENSIVE FOOLPROOF PUBLIC UNIQUEHOSPITALS FEATURES EMPOWERING THE PORTABILITY BENEFICIARY PRIVATEHOSPITALS ROBUST CASH LESS AND MONITORING PAPER LESS AND TRANSACTIONS EVALUATION
SHORTCOMINGS• Unnecessary treatment• lack of coverage for primary health and out patient care• upward escalation towards the secondary level of patients• does not take into account state specific variations in disease profiles and health needsIntensified Information, Education & Communication(IEC) activitiesCoverage of all the beneficiaries