Does Public Health System Provide Adequate Financial Protection to Its Clients Through RSBY? An Exploratory Study of Tribal Odisha

Abstract

This study estimates whether Rashtriya Swasthya Bima Yojana (RSBY) protects beneficiaries from out-of-pocket health expenditure arising at the time of illness and points out obstacles that the beneficiaries face. This article uses data of 100 beneficiaries selected through simple random sampling from the beneficiaries list that were collected from the district headquarter hospital of Mayurbhanj District, Odisha, India. This study highlights that only 8.4 per cent beneficiaries access their full healthcare services from the scheme. More than 50 per cent are forced to spend from their own pocket even though they have sum assured. The beneficiaries face problems like lack of awareness, no proper enrolment procedure, no cooperative hospital staff, limited assured money sanctioned per day, only inpatient care services, an unhygienic atmosphere in the hospital, long distance to the empanelled hospital and exploitation among health service providers. Awareness may be created among insured. The behaviour of healthcare providers may be turned friendly. Immediate attention may be provided by help desk counters to the beneficiaries. The sum assured amount may be increased. The detailed receipt of hospital expenditure may be supplied to the insured at the time of discharge.

Contemporary Universal Health Coverage in India – The Case of Federal State of Odisha (Orissa)

“…Earlier studies done on public health insurance schemes in Odisha and India found that one of the major hurdles in the way of effective utilisation of the schemes and achieving its goal of providing affordable and risk-free health coverage for the vulnerable was a lack of awareness about them. 1 , 14 , 29 , 30 The Odisha government launched a BSKY awareness drive in 2018 to raise program usage and public awareness. However, apart from some vague state government statistics, nothing is known about the scheme’s utilisation and awareness level among the population yet.…”