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RSBY, SCHIS, NHA, ABY – GOVT SCHEMES
Read more on - Polity | Economy | Schemes | S&T | Environment
- Rashtriya Swasthya Bima Yojana | Senior Citizen Health Insurance Scheme | National Health Authority | ABY | Ministry of Health and Family Welfare (MoHFW) / Labour and Employment
- RSBY – The Rashtriya Swasthya Bima Yojana (RSBY) was launched in the year 2008 by the Ministry of Labour and Employment
- It provided cashless health insurance scheme with benefit coverage of Rs.30,000 per annum on a family floater basis [for 5 members], for Below Poverty Line (BPL) families, and 11 other defined categories of unorganised workers.
- It provided financial protection against catastrophic health costs
- It improved access to quality health care for BPL and other vulnerable groups
- The premium cost was shared by Centre and the State
- The coverage extends to maximum 5 members of the family which includes the head of household, spouse and up to 3 dependents including the provision to pay transport expense
- Beneficiaries got a biometric-enabled smart card containing their fingerprints and photographs and this Single central smart card included other schemes like Aam Aadmi Bima Yojana etc.
- During 2016-2017, 3.63 crore families were covered under RSBY in 278 districts of the country and they could avail medical treatment across the network of 8,697 empanelled hospitals
- To integrate RSBY into the health system and make it a part of the comprehensive health care vision of Government of India, RSBY was transferred to the Ministry of Health and Family Welfare (MoHFW) w.e.f 01.04.2015.
- SCHIS – The MoHFW, GoI implemented the Senior Citizen Health Insurance scheme (SCHIS) for citizens aged 60 years and above, belonging to Below Poverty Line (BPL)
- It covered 11 other defined designated categories such as MGNREGA Workers, Construction Workers, Mine Workers, Licensed Railway Porters, Street Vendors, Beedi Workers, Rickshaw Pullers, Rag Pickers and Auto/ Taxi drivers with effect from 01.04.2016
- It was a top up scheme of RSBY. The health coverage was upto Rs.30,000 p.a. per senior citizen for treatment packages, over and above RSBY entitlement.
- Merger with AB-PMJAY – From March 2018, the new Centrally Sponsored Ayushman Bharat - National Health Protection Mission (AB-NHPM) subsumed both these centrally sponsored schemes – RSBY and SCHIS. They fall under MoHFW now. The scheme is run by National Health Authority (NHA), and CEO is Indu Bhushan.
- National Health Authority (NHA) – The NHA was set-up to implement the PM-JAY in India. It is an attached office of the Ministry, with functional autonomy. The NHA is governed by a Governing Board chaired by the Union Minister for Health and Family Welfare, and it has its own CEO.
- The CEO is an officer of Secretary rank to GoI
- State Health Agencies (SHAs) in the form of a society/trust run it in states
- SHAs have full operational autonomy and the NHA helps them as per need
- NHA formulates operational guidelines, model documents and contracts to ensure standardization and interoperability
- NHA determines the central ceiling for premium (or maximum central contribution for trusts) per family per year to be provided to the States/UTs
- It develops and enforces compliance with, standards for treatment protocols, quality protocols, minimum documentation protocols, data sharing protocols, data privacy and security protocols, fraud prevention and control including penal provisions etc.
- It works to prevent, detect and control frauds and abuse, etc.
- All details here – https://pmjay.gov.in/about-nha
- What it is: The Ayushman Bharat AB means 'long live India' scheme. It is a progression towards promotive, preventive, curative, palliative and rehabilitative aspects of Universal Healthcare through (a) access of Health and Wellness Centers (HWCs) at the primary level and (b) provision of financial protection for accessing curative care at the secondary and tertiary levels through engagement with both public and private sector. Also called PM-JAY.
- Meaning of terms:
- Promotive = enabling people take more control over their health status
- Preventive = care received to prevent diseases from occurring
- Curative = to cure patients, not just reduce immediate pain or suffering
- Palliative = relieve suffering in any major illness that is chronic and life-threatening
- Rehabilitative = to help patients recover and get back to leading normal lives
- World’s largest: It is expected that more than 10 crore families will be benefitted and NHPS may become the world’s largest Government funded health insurance scheme. It will incorporate the ongoing centrally sponsored schemes (CSS) – (1) Rashtriya Swasthya Bima Yojana (RSBY) and the (2) Senior Citizen Health Insurance Scheme (SCHIS).
- Details: It is a comprehensive scheme, as explained below.
- National scale – It is a national initiative launched as the part of National Health Policy 2017, in order to achieve the vision of Universal Health Coverage (UHC). It will meet the relevant Sustainable Development Goal (SDG) and its underlining commitment, which is “leave no one behind”.
- Focus – The scheme focuses on providing increased access to quality of healthcare, free medication and diagnostic services for people with low financial status. It mostly covers poor, deprived rural families and identified BPL (below poverty line) families from both urban and rural India defined as per Socio-Economic Caste Census (SECC) data. The aim is to ensure that the poor & needy do not fall back into poverty.
- Terminology – Ayushman Bharat (Modicare / NHPM) = HWCs + NHPS ( = PMJAY)
- HWCs – Establishment of Health and Wellness Centres: This is a means to deliver comprehensive primary care for all, especially for the underprivileged and vulnerable people, who cannot afford medical treatment due to the over-priced medicines and investigations. These centres will provide Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services. The first Health and Wellness Centre was launched by the PM at Jangla, Bijapur, Chhatisgarh on 14th April 2018. Target till 31-12-2022 = 1.5 lakh HWCs.
- NHPS – National Health Protection Scheme (NHPS): Under the scheme, every eligible family is entitled to an insurance benefit of up to INR 5 lakhs per year in any private (empanelled) or public hospital across the country. This enables beneficiary’s cashless treatment at any secondary and tertiary health care facility. This is based on the principle of co-operative federalism with states of India. States have to establish a State Health Agency (SHA). By June 2019, 23 lakh claims worth Rs.3077 crore had been settled.
- Number of Beneficiaries: It will target about 10.74 crore poor, deprived rural families and identified occupational category of urban workers' families as per the latest Socio-Economic Caste Census (SECC) data covering both rural and urban. The scheme is dynamic and will update as per SECC data.
- National Health Authority: The NHA was set-up to implement the PM-JAY in India. It is an attached office of the Ministry, with functional autonomy. The NHA is governed by a Governing Board chaired by the Union Minister for Health and Family Welfare, and it has its own CEO.
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