For the first time since the grandiose announcements – first in the 2016 Budget speech and then in prime minister Narendra Modi’s Independence Day speech the same year – Rs 2000 cr has been allocated for the National Health Protection Scheme. The proposal for a health cover for 50 crore people though is yet to be cleared by the cabinet more than a year after it got the nod of the expenditure finance committee.
NHPS envisages a health cover of up to Rs 1 lakh for 10 crore families with a provision for an additional Rs 30,000 for senior citizens. Beneficiaries are to be listed not just on the basis of income but on the basis of deprivations listed in the socio economic caste census. It has been modelled after the Rashtriya Swasthya Bima Yojana (RSBY), a highly successful health scheme for migrant workers below poverty line (BPL) run earlier by the labour ministry. It was transferred to the health ministry in 2015 apparently to act as the blueprint for NHPS but progress has been remarkably tardy.
NHPS which is India’s version of Universal Healrh Coverage was first unveiled in 2016 when finance minister Arun Jaitley said in his Budget speech: “Catastrophic health events are the single most important cause of unforeseen out-of-pocket expenditure which pushes lakhs of households below the poverty line every year. Serious illness of family members cause severe stress on the financial circumstances of poor and economically weak families, shaking the foundation of their economic security. In order to help such families, the Government will launch a new health protection scheme which will provide health cover up to Rs.One lakh per family. For senior citizens of age 60 years and above belonging to this category, an additional top-up package up to `30,000 will be provided.”
Six months later that commitment was reiterated by no less than prime minister Narendra Modi. Delivering his Independence Day address on August 15. 2016, Modi said: “The health care services are getting costlier and hence today from the rampart of Red Fort, our government is announcing an important step for the health care of such families which are below the poverty line. We have brought a scheme that in future, for such poor families the government of India will incur an expenditure of upto 1 Lakh rupee so that my poor brothers are not deprived of health services and their dreams are not shattered.”
Estimated to cost Rs 6,000 crore annually, NHPS has already been approved by the Expenditure Finance Committee. The Rs 2000 crore allocation is the first major allocation for the programme since it was announced. It has raised hopes that at least a pilot may see the light of the day within the 2017-18 financial year that was the deadline for its rollout.
“We have for the first time got Rs 2000 crore for NHPS,” said a senior health ministry official. While the health ministry waited for a decision on. NHPS, spending on RSBY that came with a total of 3.72 crore beneficiaries has been dipping. In 2015 Rs 670 crore was spent on RSBY, in 2016 that amount came down to Rs 450 crore.
An evaluation of RSBY published last year in the Journal of Social Medicine and co-authored by professors from the Harvard T H Chan School of Public Health pointed out that the low cap of Rs 30,000 and the fact that OPD care is not covered make RSBY largely self-limiting.
