Evaluation of “Rashtriya Swasthya Bima Yojana”(RSBY), a Health Insurance Scheme for Below Poverty Line (BPL) People in India

Wednesday, April 25, 2012
E: Andrija Stampar Hall (Millennium Hall)
Prateek. M. Rathi, MBBS, MS, LLB, MBA, Fellow, Member, Public, Policy, IIM, Bangalore. Government of Maharashtra, India
Objectives: The research program was undertaken to evaluate the recently launched RSBY (National Health Insurance Scheme), a fully subsidized Health Insurance scheme for poor people in India. The study objective was to evaluate the efficacy of the scheme in terms of equity, beneficiary perception, experience, design & management.

Background: The workers in the unorganized sector constitute about 94% of the total workforce in the country. One of the major insecurities for workers is absence of health cover leading to medical impoverishment. To provide health insurance to BPL workers in the unorganized sector, government has announced the RSBY.

Methodology: A community based survey was done in randomly selected 8 blocks out of 13 blocks of Amravati District from July 2010 to October 2010.  The sample size was of 810 Households, who were having RSBY cards, information regarding their demographics, household assets & healthcare needs was obtained. 280 RSBY beneficiaries were interviewed to know the experience & perception of the scheme  

 Results: The study revealed that the scheme was utilized by all age groups & either sex but had a negative correlation in respect of distance to utilization of benefit. The other barriers to utilization of benefits were lack of information, late enrolment & transportation. The tribal blocks which had the maximum poor BPL households saw the least enrolment & beneficiaries. The scheme had an adverse impact on ongoing governmental healthcare programs, & duplication of efforts & wastage of scarce governmental resources was seen. 

 Conclusions & Implications: There cannot be a substitute for a well functioning, effective and efficient public healthcare system and health insurance schemes like RSBY can play only a complementary role. Planners should understand that parallel schemes which run on public money can only introduce wastage and inefficiencies into the system unless well designed in terms of management.


Learning Objectives: Present study critically evaluates and analyses the Rashtriya Swasthya Bima Yojana, a health insurance scheme for below poverty line people in terms of equity and design and identifies gaps and weaknesses. It also discusses beneficiary perception and experience of RSBY and barriers to utilization of benefits of the scheme. The study recognizes the importance of an efficient and effective public health system and discusses how health insurance scheme like RSBY can play a complimentary role in reducing medical impoverishment if designed properly.
See more of: Health Insurance
See more of: Health Insurance, Social Health Insurance, Micro Insurance; Implications for Public Health
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