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Study On Health Insurance Schemes In India

4537 words - 19 pages

STUDY ON PUBLIC SPONSORED HEALTH INSURANCE SCHEMES IN INDIA
Abstract
The main of this study is to analyse the public sponsored health insurance models in India. The main aim of government sponsored health insurance schemes is to assist the BPL families in catastrophic health expenditure and thereby provide them access to quality health care. This report goes through the working procedure of health insurance schemes, especially Rajiv Aarogyasri (Andhra Pradesh), Vajpayee aarogyasri (Karnataka) and Chief Ministers Comprehensive health insurance scheme (Tamil Nadu) and analyse how far they succeeded in their respective aims.
Introduction
Health insurance as a measure to uplift the living ...view middle of the document...

In most cases this becomes a health shock to the poor households who eventually fall under permanent indebtedness. This accounts for the statistics showing the major proportion of overall health expenditure of about 5% of GDP is met by out-of-pocket expenditure and accounts for 98.4% of total health expenditure of Indian households. There comes the importance of publically funded community health insurance schemes targeting the BPL section.
Among the government funded health insurance schemes that helped to bring a drastic change in the scenario are central government funded Rashtriya Swasthya Bima Yojana (RSBY), state government funded Rajiv Aarogyasri Community Health Insurance Scheme-RACHIS (Andhra Pradesh), Kalaignar’s Insurance Scheme for life Saving Treatment (Tamil Nadu) and Vajpayee Arogyasri & yeshasvini programs (Karnataka). The success of these schemes is they were able to cover a large percentage of population (especially the poor section) within a very short span of three years. These schemes cover over one-fifth of India’s population.
Objective of the study
The objective of this study is to analyse;
* the working models of community health insurance schemes like Rajiv Aarogyasri in AP, Vajpayee Arogyasri in Karnataka and Kalaignar Insurance (which is changed to Chief Ministers Comprehensive Health Scheme in 2012),
* how far they succeeded in achieving their aim of protecting poor families from huge out of pocket payment for treatment of serious ailments
* how effectively are they carrying on with the schemes and
* Can these models be used replicate in other states?

The study first goes through detail analysis of public health Insurance Schemes. How they work, how they are funded, who all are the beneficiaries, who are the insurer, how the Private Public Partnership model works in this industry are some of the issues analysed in this report.

Background
Even though the Government of India had started the public funded health insurance schemes in 1950s, large part of population was not covered by these insurance schemes. This was mainly because those insurance schemes were mainly targeting either Central or State Government employees, like Central Government Health Scheme (CGHS) and Employee’s State Insurance Scheme (ESIS), where the former one is for Central Government employees and the latter one targeting State Government employees. The privatisation of health insurance came in the year 1999 only and there is still hope for further expansion in this field. More private health insurance companies are coming up but still a large proportion of the population is not covered under any health insurance schemes. Thus from 2005 both Central Government and State government were initiating to support the poor in catastrophic health expenditure for serious tertiary treatments. Later this initiative was institutionalised into various insurance schemes.

Following figure 1 shows the time line of health...

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