Centre copies Karnataka insurance model

Centre copies Karnataka insurance model

The Union Health Ministry plans to make the government-funded medical insurance scheme more poor-friendly by increasing the reimbursement ceiling; covering life style diseases and changing the scheme's management pattern on the lines of the Karnataka model.

The proposed modified Rashtriya Swasthya Bima Yojna (RSBY) is being discussed within the government, which aims to expand social security cover for the poor.

The RSBY revamp follows the government’s decision to transfer the scheme to the health ministry from the labour ministry, which was operating it for the last seven years.

“One of the new proposals under RSBY is to check the health and wellness profile of every 30 plus individual, willing to be a part of the scheme. The check up will be once in three years,” said a health ministry official.

Another important addition would be primary care and management of diabetes and hypertension – two lifestyle diseases whose prevalence is growing  rapidly. A committee of secretaries has proposed increasing the reimbursement ceiling from the existing Rs 30,000 to Rs 50,000.

“Raising the (reimbursement) ceiling would not be an issue as only two per cent beneficiaries utilise the ceiling amount at the moment,” he told Deccan Herald.

A more troublesome question is to determine which model to follow in revamping the RSBY. The two options before the government are trust-based model as in Karnataka and the insurance based health care system.In the first, a government-funded trust processes and settles the claim. In the second, the government joins hands with insurance companies, which are selected through a competitive process.
 

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