Over the past few decades, access to healthcare in India has certainly improved, but India still continues in miserable condition amongst the worst providers of healthcare. Out-of-pocket expenses are the primary cause of indebtedness for the poor. The key issue is how to reach out to the population at the bottom of the pyramid.
Rashtriya Swasthya Bima Yojana (RSBY) is gradually demonstrating that there can be a business model for a social sector scheme, where markets do not necessarily work against the poor but can bring about efficiency in delivering public services that are delivered by the government or its agencies. At present, under RSBY, the central and state governments share the premium for health insurance cover.
The beneficiary pays only Rs. 30 as registration fee. The delivery of healthcare services is by public and private sector insurance companies that cover the risk. There are more than 8,000 hospitals, public and private, spread across the country which provides in-patient health care. The scheme, thus, illustrates how public-private partnership can successfully deliver a social sector scheme.
The scheme empowers the poor and gives them free access to healthcare in any of these hospitals anywhere in the country with a smart card enabling the portability of entitlements.
Insurance companies issue as many smart cards as possible because the amount paid to them is a multiple of the cards issued. A smart card cannot be issued to a wrong person because of the inbuilt security and verification system.
The poor beneficiary is not chased away by the hospital as they carry a credit of Rs. 30,000 on their smart card chip. There is a fortune waiting for them at the bottom of the pyramid.