NEW DELHI: The government’s ambitious mega health care programme for 10 crore poor families will roll out by October 2 and is to be funded in a 60:40 proportion by the Centre and states, with the premium per family estimated at Rs 1,000-1,200.
Ten crore families or 50 crore beneficiaries+ , classified as ‘deprived’ in the socio-economic caste census of 2011, will be covered by the scheme. It will be a cashless Aadhaar-linked facility with beneficiaries availing treatment anywhere in the country in empanelled private or public hospitals.
With some experts questioning+ how the scheme will be funded and the quantum of premium, Niti Aayog has calculated an outgo of Rs 10,000-12,000 crore a year for the Centre and is confident of successful implementation with the help of low premiums it hopes to get from insurance firms.
To substantiate their optimism, government sources pointed out that the Rajasthan government currently offers a cover of Rs 3.75 lakh a year for a premium of Rs 500 per family and the utilisation or claims rate is around 2.5%.
Officials said the national health protection scheme unveiled by finance minister Arun Jaitley in Parliament on Thursday is much larger and, thus, offers considerable leeway for striking a bargain with insurers.
Officials said various state schemes and global examples had been studied by Niti Aayog before a presentation was made to PM Narendra Modi and the FM.
As of now, Budget 2018-19 has allocated only Rs 2,000 crore for the existing insurance scheme, Rashtriya Swasthya Bima Yojana, which will be channelised for implementing NHPS initially.
Govt will require Rs 5,000-6,000 crore to start scheme
Director-general of health services Dr B D Athani said NHPS would help reduce impoverishment due to high cost of treatment. “Nearly six to seven crore people fall into poverty every year due to medical expenses. The insurance scheme will help check this trend,” he said.
Allaying fears about funding of the ambitious project, Niti Aayog member V K Paul said the government would have additional resources of Rs 11,000 crore through the additional 1% cess introduced in the Budget.
“The expected coverage for the first year based on states’ acceptance is 50%. The government will require Rs 5,000-Rs 6,000 crore to start the scheme,” said Niti Aayog CEO Amitabh Kant.
Health minister J P Nadda held a media briefing to allay concerns over the scheme, touted as the world’s largest government-funded healthcare programme, and along with Niti Aayog outlined financing as well as a timeline for implementation and rejected the opposition’s charge that NHPS is a ‘jumla’.
Paul said the Aayog has been working on the project for one-and-a-half years. “We have held meetings with state representatives also on the issue. Further meetings will be held over the next few days to work out the nitty-gritty so that the scheme is available to beneficiaries by October 2,” Dr Paul said.
NHPS will replace RSBY, which was launched in early 2008 for those below the pover-ty line (BPL) and provided an annual coverage of only Rs 30,000.
States like Rajasthan, Karnataka, Andhra Pradesh and Tamil Nadu run their medical insurance schemes where most of the premium is borne by the state while in some cases beneficiaries pay a token amount. However, coverage is only up to Rs 3 lakh.
Paul said once NHPS comes into force, states will have to align with its procedures but will have the flexibility on how to implement it. “The states can choose to rope in a public insurance company or create a trust to run the insurance scheme,” he added.