The Planning Commission has proposed the introduction of a state-funded health insurance programme by 2017 to cover every citizen of the country.
The panel has suggested that the government formulate financial incentives for beneficiaries of the insurance programme as well as their employers to encourage them to participate in the plan.
“The 12th Plan (2012-17) will explore the possibilities of introducing a government-funded health insurance plan for every citizen along the lines of the Rashtriya Swasthya Bima Yojana (RSBY), which is currently limited to the poor and for certain select groups,” says the approach paper to the 12th Plan, which has been approved by the Union cabinet. “The premiums should be contributed both by the beneficiaries and their employers.”
RSBY, introduced in 2008, has provided health cover to about 24 million poor people in the country. The plan provides a cover of Rs. 30,000 a year to a family of as many as five people. It covers most surgical and medical needs.
The government and insurance firms are still grappling with the problem of some people fraudulently obtaining payments from insurers under the scheme.
Insurance company executives say the government needs to do a thorough homework before implementing the proposed universal health insurance plan.
Implementation will be a challenge because of India’s diverse demography, climate, scattered poor families and poor infrastructure, said Antony Jacob, chief executive of Apollo Munich Health Insurance Co. Ltd.
“Robust IT projects would be required to make this proposal a success,” he said. “Only about 12-13% of the population has some form of health insurance coverage, apart from the 10% who are covered through some form of government schemes.”
Amarnath Ananthanarayanan, chief executive of Bharti Axa General Insurance Co. Ltd, said it’s a step in the right direction but the government needs to decide on a few things, including “the definition of healthcare, who’ll fund it, whether it will be a public-private partnership and whether it will be for families both above and below the poverty line”.
The success of the unique identification (UID) project is critical for the implementation of the programme as it will help prevent fraud, he said.
UID plans to provide a unique number to all Indians that can be used by the government to identify individuals eligible for subsidies and other entitlements.
Involving the employee and employer in the health cover plan will leave out many of the people who work in the unorganized sector, said Aloke Gupta, an independent health insurance consultant.
“When you talk about employees and employers, does this mean the government is looking to cover only the organized sector, which is only around 30 million, and leave out the majority of the informal sector,” he said.
Details of the plan will be formulated once the actual implementation starts, said a Plan panel official, who declined to be identified. “This is just the idea now. When actual implementation happens then all these concerns will be addressed.”