Challenges in the Sustainability of a Targeted Health Care Initiative in India

Abstract

In this article, we raise sustainability issues in a targeted health initiative, namely the Rashtriya Swasthya Bima Yojana. This unique health insurance initiative targets the poor population to address the iniquity in healthcare in the Indian societal context. We analyse this initiative because it is a unique case of a public private partnership in the development sector arena in India being used as an instrument for improving health care system in a large scale. The initial success stories from this initiative include improved hospitalisation rates for the targeted population, a reduction in their out-of-pocket healthcare spending, and a reasonable incentive encouraging the participation of insurance companies. The sustainability of this initiative, however, is threatened mainly by a lack of information, heterogeneity in access, institutional shortcomings, and the longrun escalation of costs. While the government is employing a public-private partnership to implement this initiative, there is need to simultaneously use this model to augment the existing health infrastructure to make this initiative sustainable and effective.

Government sponsored health insurance coverage and out-of-pocket spending among elderly in Kerala: a cross-sectional study

“…In other words this scheme did not cover almost two third of the hospitalizations among insured which it supposed to cover and by default did not cover the out-patient visits which constitutes more than 70% of the total health care utilization among elderly in India. 28,29 This also reflects the number and quality of the hospitals empanelled under CHIS.…”

The Government-sponsored Health Insurance Schemes for the Gross Domestic Healthiness

“…Though GSHISs for those below the poverty line is widely praised as a success, they offer limited financial protection, suffers from corruption, abuse and cost escalation, and has skewed public resources to curative rather than preventative care (Balooni, Gangopadhyay, Turakhia & Karthik, 2012). The very nature of government interventions, heterogeneity in operations and beneficiaries considering the GSHIS as yet another subsidy of a political party, not realizing the very nature of health insurance, make the system uncontrollable.…”

Falling Sex Ratio and Health Deprivation of Women in India: An Interface between Resource, Culture and Gender

“…16. For instance, the Rastriya Swasthya Bima Yojana, aiming to take care of resource scarcity of the poor households, has failed to a large extent in this regard as there is evidence of gender disparity in its availing by the households (Balooni et al 2012 (2) In NFHS-2, separate data are not available for Jharkhand, Chhattisgarh, Uttaranchal, and Delhi; data for Jammu and Kashmir is also not available. Source: Registrar General, India (2011); IIPS (1995IIPS ( , 2008; IIPS and Macro International (2007).…”