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……………  a journey called RSBY
STRUCTURE OF THE PRESENTATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Workforce In India ,[object Object],[object Object],[object Object]
WHY SOCIAL SECURITY? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Major Needs of Unorganised Sector workers ,[object Object],[object Object],[object Object],[object Object]
RECENT INITIATIVES TO PROVIDE SOCIAL SECURITY TO THE UNORGANIZED SECTOR WORKER ,[object Object],[object Object],[object Object],[object Object],[object Object]
HEALTH INSURANCE COVERAGE  VERY LOW OOP = 83% of total health spending in India Data for All- India 2004
OUT OF POCKET (OOP) EXPENSES AND INDEBTEDNESS IN INDIA (Amount in $US)  ALL INDIA POOREST 1. Average OOP Payments made per hospitalization in Govt. facilities 70 54 2. Average OOP Payments made per hospitalization in private facilities 158 115 3. %age of people indebted due to OP Care 23 21 4. %age  of people indebted due to IP Care 52 64 SOURCE: NSSO, GOI
SOME OF THE KEY ISSUES WHILE CONSIDERING A HEALTH INSURANCE SCHEME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHARACTERISTICS OF UNORGANIZED SECTOR WORKERS ,[object Object],[object Object],[object Object]
RASHTRIYA SWASTHYA  BIMA YOJANA The Scheme ,[object Object],[object Object],[object Object]
RASHTRIYA SWASTHYA  BIMA YOJANA Benefits ,[object Object],[object Object],[object Object],[object Object]
FUNDING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insurance Company State Nodal Agency Health Care  Providers 7. Enrollment of Beneficiaries FKO 7. Verification of Smart Card Government  of India BPL Data www.rsby.in 5. Empanelment District Kiosk DKM Call Centre 5. Setting-up Setting-up 1. Prepare in given format 2. Send for verification 3. Upload on website after verification  4. Selection through tendering 6. Issuance of FKO Card 8. Download of FKO Data at DKM server 9. Submission of  data and bill 10. Payment to Insurer 11. Utilisation of Services 12. Claim Process Awareness Health Camps BPL Beneficiaries
SMART CARD
BPL DATA MANAGEMENT SOFTWARE KEY MANAGEMENT SYSTEM SOFTWARES CARD OPERATING SYSTEM SOFTWARE ENROLMENT SOFTWARE DATA  TRANSMISSION  SOFTWARE TRANSACTION  SOFTWARE DISTRICT  KIOSK  SOFTWARE 10 8 7 1 6 3 2 4 5 SMART CARD, I.T. APPLICATIONS & RSBY ENROLMENT DATA DOWNLOAD SOFTWARE BACK-END DATA  MANAGEMENT SOFTWARE 11 9
INITIAL CHALLENGES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
WHAT WAS REQUIRED TO BE DONE DURING THE INITIAL PHASE? ,[object Object],[object Object],[object Object]
TASKS DURING THE INITIAL PHASE Insurance and Medical Services Related Activities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TASKS DURING THE INITIAL PHASE   Information Technology Related Issues ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TASKS DURING THE INITIAL PHASE  Marketing of the Scheme ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HOW IS RSBY DIFFERENT? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ENROLMENT KIT
FIRST RECIPIENT OF SMART CARD Village:  Chappar ; District:  Yamunanagar ; State:  Haryana
RSBY - Enrollment
WHERE DID IT ALL BEGIN?
Current Status of Implementation of RSBY   …. since its roll out from 1.4.08 Category Numbers Number of People Covered 75 million Number of people benefitted 700,000 Number of States Started the Process 26 Number of States Distributing Smart Cards 22 Number of States where Policy has Started 22 Number of Insurance Companies involved 11 Number of Smart Cards Distributed 18.5 million
INITIAL INDICATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Note:  Estimate based on monthly hospitalizations; includes multiple procedures within same household in case of RSBY
Note:  78 districts are sorted by male utilization rate (blue line). If female utilization rate (red dot) is higher than male one, then red dot is above blue line.
Note:  Estimates are based on ALL districts with RSBY program, both completed and in progress
Public sector hospitals must play key role in RSBY and can benefit from RSBY as well  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BURN-OUT RATIO FOR 92 DISTRICTS WHERE ONE YEAR COMPLETED ,[object Object],[object Object],[object Object],[object Object],[object Object],B+C+D   X 100 A Burn Out Ratio: 90.70 %
PERCEPTIONS ABOUT THE SCHEME ,[object Object],[object Object],[object Object]
……… .evaluation surveys
Beneficiary Response to the Treatment Provided in the Hospitals SOURCE: Evaluation Survey in Kerala by The Research Institute, Rajagiri College of Social Sciences
Beneficiary Response to the Overall Experience at the Hospitals SOURCE: Evaluation Survey in Kerala by The Research Institute, Rajagiri College of Social Sciences
Service Delivery –  Health Status Post RSBY Treatment Source: Survey conducted by  The  Research  Institute Rajagiri  College  of  Social  Sciences  2009 Health Status Percent Has improved completely 89.8 No improvement 0.9 Partially improved 9.3 Total 100.0
BENEFICIARY RESPONSE IN DELHI ,[object Object],[object Object],[object Object],Source: Survey organised  by GTZ and World Bank in Delhi, 2009
BENEFICIARY RESPONSE IN DELHI ,[object Object],[object Object],Source: Survey organised  by GTZ and World Bank in Delhi, 2009
……… ..…..in the media
 
“ For the nation,  it is the best Diwali present amidst all the gloom in the marketplace”
 
 
 
 
 
 
BBC ,[object Object],[object Object],[object Object]
……… .international agencies
The World Bank ,[object Object],[object Object]
Bill Gates Foundation ,[object Object],[object Object]
RECOGNITION BY UNDP AND ILO ,[object Object]
WHY DID RSBY HAPPEN and  ARE THERE ANY LESSONS? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Challenges Ahead ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
……… .we haven’t arrived as yet but the journey so far has been extremely enjoyable.

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RSBY - A Journey to Health Security

  • 1. …………… a journey called RSBY
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. HEALTH INSURANCE COVERAGE VERY LOW OOP = 83% of total health spending in India Data for All- India 2004
  • 8. OUT OF POCKET (OOP) EXPENSES AND INDEBTEDNESS IN INDIA (Amount in $US) ALL INDIA POOREST 1. Average OOP Payments made per hospitalization in Govt. facilities 70 54 2. Average OOP Payments made per hospitalization in private facilities 158 115 3. %age of people indebted due to OP Care 23 21 4. %age of people indebted due to IP Care 52 64 SOURCE: NSSO, GOI
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. Insurance Company State Nodal Agency Health Care Providers 7. Enrollment of Beneficiaries FKO 7. Verification of Smart Card Government of India BPL Data www.rsby.in 5. Empanelment District Kiosk DKM Call Centre 5. Setting-up Setting-up 1. Prepare in given format 2. Send for verification 3. Upload on website after verification 4. Selection through tendering 6. Issuance of FKO Card 8. Download of FKO Data at DKM server 9. Submission of data and bill 10. Payment to Insurer 11. Utilisation of Services 12. Claim Process Awareness Health Camps BPL Beneficiaries
  • 16. BPL DATA MANAGEMENT SOFTWARE KEY MANAGEMENT SYSTEM SOFTWARES CARD OPERATING SYSTEM SOFTWARE ENROLMENT SOFTWARE DATA TRANSMISSION SOFTWARE TRANSACTION SOFTWARE DISTRICT KIOSK SOFTWARE 10 8 7 1 6 3 2 4 5 SMART CARD, I.T. APPLICATIONS & RSBY ENROLMENT DATA DOWNLOAD SOFTWARE BACK-END DATA MANAGEMENT SOFTWARE 11 9
  • 17.
  • 18.  
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  • 21.
  • 22.
  • 23.
  • 25. FIRST RECIPIENT OF SMART CARD Village: Chappar ; District: Yamunanagar ; State: Haryana
  • 27. WHERE DID IT ALL BEGIN?
  • 28. Current Status of Implementation of RSBY …. since its roll out from 1.4.08 Category Numbers Number of People Covered 75 million Number of people benefitted 700,000 Number of States Started the Process 26 Number of States Distributing Smart Cards 22 Number of States where Policy has Started 22 Number of Insurance Companies involved 11 Number of Smart Cards Distributed 18.5 million
  • 29.
  • 30. Note: Estimate based on monthly hospitalizations; includes multiple procedures within same household in case of RSBY
  • 31. Note: 78 districts are sorted by male utilization rate (blue line). If female utilization rate (red dot) is higher than male one, then red dot is above blue line.
  • 32. Note: Estimates are based on ALL districts with RSBY program, both completed and in progress
  • 33.
  • 34.
  • 35.
  • 37. Beneficiary Response to the Treatment Provided in the Hospitals SOURCE: Evaluation Survey in Kerala by The Research Institute, Rajagiri College of Social Sciences
  • 38. Beneficiary Response to the Overall Experience at the Hospitals SOURCE: Evaluation Survey in Kerala by The Research Institute, Rajagiri College of Social Sciences
  • 39. Service Delivery – Health Status Post RSBY Treatment Source: Survey conducted by The Research Institute Rajagiri College of Social Sciences 2009 Health Status Percent Has improved completely 89.8 No improvement 0.9 Partially improved 9.3 Total 100.0
  • 40.
  • 41.
  • 43.  
  • 44. “ For the nation, it is the best Diwali present amidst all the gloom in the marketplace”
  • 45.  
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  • 48.  
  • 49.  
  • 50.  
  • 51.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58. ……… .we haven’t arrived as yet but the journey so far has been extremely enjoyable.