Rashtriya Swasthya Bima Yojana: evaluating utilisation, roll-out and perceptions in Amaravati district, Maharashtra

Abstract

A study conducted of the Rashtriya Swasthya Bima Yojana in 2009-10 in Amaravati district of Maharashtra shows that there are critical concerns in the very design and implementation of the programme that may make it challenging for RSBY to reach its target of below the poverty line population. Thus, the poor in the more remote blocks and villages may be ignored for easier to reach potential enrollees as the premia paid for all are the same. Empanelled hospitals tend to be placed near district headquarters, raising costs of access for the poor beyond that covered in the programme and packages do not recognise treatment and care uncertainties that incentivise hospitals to treat simpler and less complicated diseases. Additionally, a lack of adequate planning for change in insurance providers creates breaks in service that are avoidable. In spite of these shortcomings users rate this programme highly and this underlies the importance of providing access to a functional healthcare system to the poor.