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Rashtriya Swasthya Bima Yojana (RSBY) for Universal Health Coverage

Author

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  • Pawan Kumar Taneja
  • Shallini Taneja
Abstract
On 10 June 2012, Anil Swarup, Additional Secretary, Ministry of Labour & Employment, Government of India (GOI), reviewed the report submitted to the Planning Commission of India by High Level Expert Group (HLEG) on universal health coverage (UHC) for India; 1 he had mixed feelings about this report. It (HLEG) reported that the main impeding factor to UHC in India is the heavy out-of-pocket (OOP) expenditure on health, that is, 61.7 per cent of the total health expenditure by Indians as compared to the global average of 20.5 per cent. Looking for a solution for this problem, the report appreciated his brainchild, the Rashtriya Swasthya Bima Yojana (RSBY), a social health insurance scheme rolled out in 2008 to reduce OOP expenditures for healthcare. The scheme also aimed to cut down a substantial financial burden on the poor by the GOI. The RSBY scheme was lauded for its innovative approach in financing mechanism, 2 public private partnership (PPP) model for enrolment process, use of information and communication technology for delivery of healthcare services. However, the report questioned the potential of RSBY to achieve UHC due to issues in its sustainability. The scheme faced challenges of low coverage ratio, unfair practices in enrolment and hospitalization processes in many parts of the country, inconsistent usage patterns of services, and backing out by insurance companies as result of high claims ratio. 3 Swarup was in a dilemma of how to address these issues and make RSBY a platform to implement universal health coverage (prime area of concern for GOI) in India.

Suggested Citation

  • Pawan Kumar Taneja & Shallini Taneja, 2016. "Rashtriya Swasthya Bima Yojana (RSBY) for Universal Health Coverage," Asian Journal of Management Cases, , vol. 13(2), pages 108-124, September.
    • Handle: RePEc:sae:anjomc:v:13:y:2016:i:2:p:108-124
    DOI: 10.1177/0972820116653335
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    1. Shaohua Chen & Martin Ravallion, 2010. "The Developing World is Poorer than We Thought, But No Less Successful in the Fight Against Poverty," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(4), pages 1577-1625.
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    1. Jena, Pradyot Ranjan & Khosla, Sunil & Rahut, Dil Bahadur, 2024. "Can farmers with higher capabilities fend off falling into future Poverty? Empirical evidence from a tribal region in eastern India," World Development Perspectives, Elsevier, vol. 33(C).
    2. Sunil Khosla & Pradyot Ranjan Jena, 2023. "Using Multidimensional Poverty Measure to Target Right Beneficiaries to Achieve Sustainable Development Goal-1 in India," Indian Journal of Human Development, , vol. 17(2), pages 290-309, August.
    3. Mohd Zuhair & Fuli Zhou & Saurabh Pratap & Ram Babu Roy, 2022. "Eliciting key attributes of health insurance in rural India: a qualitative analysis," SN Business & Economics, Springer, vol. 2(3), pages 1-28, March.

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