The Rashtriya Swasthya Bima Yojana (RSBY), which insures families of unorganised sector workers for up to Rs. 30,000 of medical care, is expected to be transferred from the Ministry of Labour and Employment to the Union Health Ministry.

The RSBY, operationalised in 2008 by the UPA government, will be merged with the Universal Health Assurance Mission (UHAM) proposed by the NDA government.

Officials of the Labour Ministry and the Health Ministry confirmed that the scheme, which covers secondary care, hospitalisation expenses up to Rs. 30,000 at empanelled public and private hospitals at present, is set to be expanded to include tertiary care for major surgeries, accompanied by increasing coverage beyond Rs. 30,000.

“The Labour Ministry had identified three main challenges — not enough hospitals were empanelled in blocks and districts, pathways for disease to be outlined to avoid hospitals carrying out unnecessary medical procedures and insurance companies had not been paid dues on time,” a senior official said.

“By the time the Ministry began acting, there was the impression that the scheme was not doing well under the Labour Ministry and a political decision was taken to shift it to Health, where UPA had originally proposed to house RSBY,” he added.

The NDA government has proposed to make RSBY a part of UHAM, a promise in the BJP manifesto under which a limited number of generic drugs and diagnostic services will be available to all citizens. Health Ministry officials said the proposal would build on RSBY providing only a supplementary role to private health care providers.

“Right now only secondary care hospitalisation is taken care of, and the proposal is to bring more tertiary, primary care into it. Out-patient and ambulatory care will get covered too to have a continuum of care. A team will be set up to work specifically on this,” said a senior official in the Health Ministry.

Families of unorganised sector workers will get an increase in coverage and tertiary care for major surgeries

http://www.thehindu.com/todays-paper/tp-national/swasthya-bima-yojana-to-be-merged-with-uham/article6521159.ece