Fact Check

Health Check on Swasthya Bima Yojana

The ‘public’ in public health

The Hindu, May 16, 2017

The article tries to raise concerns about the Central government’s health insurance scheme, the Rashtriya Swasthya Bima Yojana (RSBY), questioning its efficacy and outreach. It also points its finger at the government’s “lack of mandate” on insurance companies.


The article does not account for the changes brought about by the government in the insurance industry. It also tries to downplay the fact that the budget allocation for the scheme has increased. Moreover, the initiatives taken by the government to increase the number of enrolments as well as the redress mechanism in place for issues related to RSBY do not find a mention in the article.


Let’s take a look at some of the facts pertaining to RSBY:

  • The total allocation for RSBY is Rs 2,250 crore in 2017-18, a 10% increase over the revised estimates of 2016-17
  • Prices of as many as 700 medicines have been fixed to ensure affordability
  • Three-tier structure of Grievance Redressal Committees: National Grievance Redressal Committee (NGRC) at the national level, State Grievance Redressal Committee (SGRC) at the state level, District Grievance Redressal Committee (DGRC) at each district are in place
  • There are dedicated toll-free helplines to address all queries and issues related to the scheme
  • Senior Citizen Health Insurance scheme (SCHIS): Senior Citizens of age 60 years and above, who are Below Poverty Line (BPL), and 11 other defined designated categories will benefit from health coverage
  • This coverage is Rs 30,000 per annum per senior citizen for treatment packages, over and above RSBY entitlement
  • Government has relaxed FDI norms for the insurance sector by permitting overseas companies to buy 49 per cent stake in domestic insurance firms without prior approval
  • As of March 31, 2016, there were 41,331,073 Active Smart Cards

The above facts show that budgetary allocation for the RSBY has actually increased in total terms. In 2016-17, RSBY allocation increased by 149% over the revised estimates for 2015-16. Given that India has a high out-of-pocket (OOP) expenditure rate on healthcare, the issue has been addressed by fixing prices for around 700 medicines which will make healthcare more affordable for the poor. Moreover, the integration of the new SCHIS scheme along with RSBY aims at making healthcare accessible for senior citizens as well. To further increase insurance enrolment, FDI norms have been eased. With 49% FDI, there are new companies willing to enter the Indian market and increase the insurance coverage. RSBY also stands to benefit from this move.


  • 10% budget increase from 2016-17 to 2017-18
  • Prices of 700 medicines fixed for affordability
  • Dedicated helplines to address concerns
  • SCHIS provides insurance cover to senior citizens
  • FDI in insurance increased to 49%
  • 41,331,073 Active Smart Cards of March 2016

Fixed pricing for drugs will make healthcare more affordable for the poor and curtail malpractice. Apart from that, with the easing of FDI norms for the insurance industry and initiatives like SCHIS as well as dedicated helplines, RSBY enrolments are likely to increase.