Implementation of RSBY in Karnataka and Universal Health Coverage in India E. Lakshmappa Joint Labour Commissioner and CEO Shantveer M Patil Additional CEO Government of Karnataka: Department of Labour Karnataka State Rashtriya Swasthya Bima Yojana Society

A glimpse of RSBY Pilot Phase (5 Districts): , Pilot Phase (5 Districts): , Roll Out Phase (All 30 Districts): , , Roll Out Phase (All 30 Districts): , , Current Phase (All 30 Districts): , , Current Phase (All 30 Districts): , , IdentifiedEnrolledUtilized Amount (Rs/Cr) NetworkHospitalsPremium Rate (Avg) Conversion Ratio % Pilot Phase Roll Out Phase Current Phase *50541*30.10*761* *As on

Some Statistics 64 lac enrolled families Average family size 3.5 (approx) 2.24 Cr individuals covered (64 lac X 3.5) Utilization beneficiaries/individuals amounting INR 30 Cr Utilization Average INR 6000 per beneficiary Every 128 families or 450 individuals 1 beneficiary INR 120 Cr approx premium payout (64 lac X 189 average premium) Currently cost per beneficiary INR (INR 120 Cr / beneficiaries) Projections: beneficiaries/individuals INR Cr  Utilization Average INR 7500 per beneficiary  Then the cost per beneficiary/individual would be INR (INR 120 Cr / beneficiaries)  Then the utility is 75%, Every 53 families or 187 individuals 1 beneficiary The achievement in the 3 rd round (actually 2 nd round) is remarkable It is envisaged 150% utilization in the coming round

What is RSBY? GoI initiated, Centrally Sponsored Scheme A Flagship Health Insurance Program Cashless and Paperless program Premium sharing in the ratio of 75:25 between GoI and GoK Plus Cost of the Smart Card is paid by GoI BPL and few unorganized sector families (NW, MW, DW, BW, CW, SW, RP, Cycle Pullers, Auto/Taxi Drivers, Railway Porters) Family consisting 5 members (HoF, Spouse and 3 others) are covered New born during the policy period is covered INR per family per year 1516 procedures, provision for additional procedures on Pre-Authorization mechanism Existing ailments are also covered Transportation Charges of INR 100 per visit (max INR 1000/year) Premium payable to Insurance Companies include deliverables: Issuance of Smart Cards, Networking Hospitals, Claims Settlement The scheme is implemented by the State Nodal Agency (SNA) Karnataka State Rashtriya Swasthya Bima Yojana Society, under the administrative control of Labour Dept

RSBY Life Cycle Assessment

Society Karnataka State Rashtriya Swasthya Bima Yojana Society Commissioner of Labour-Chairman Commissioner of Labour-Chairman Joint Labour Commissioner-Chief Executive Officer Joint Labour Commissioner-Chief Executive Officer Director, ESI Services-Member Director, ESI Services-Member Commissioner, Health & Family Welfare Dept-Member Commissioner, Health & Family Welfare Dept-Member Addl/Joint Director/Deputy Secretary Finance Dept-Member Addl/Joint Director/Deputy Secretary Finance Dept-Member Addl/Joint /Deputy Secretary Health & Family Welfare Dept-Member Addl/Joint /Deputy Secretary Health & Family Welfare Dept-Member Addl/Joint/Deputy Secretary Rural Development & Panchayat Raj Dept-Member Addl/Joint/Deputy Secretary Rural Development & Panchayat Raj Dept-Member Governing Bodies RSBY Governing Bodies State Coordination Committee- Chaired by the Chief Secretary State Coordination Committee- Chaired by the Chief Secretary State Level Convergence Committee - Chaired by the Chief Secretary State Level Convergence Committee - Chaired by the Chief Secretary Inter-Department Task Force Committee- Chaired by the ACS/ Pr. Secy/ Secy Dept of Labour Inter-Department Task Force Committee- Chaired by the ACS/ Pr. Secy/ Secy Dept of Labour State Grievance Redressal Committee- Chaired by the ACS/ Pr. Secy/ Secy Dept of Labour State Grievance Redressal Committee- Chaired by the ACS/ Pr. Secy/ Secy Dept of Labour District Implementation Committee- Chaired by the DC District Implementation Committee- Chaired by the DC District Grievance Redressal Committee- Chaired by the DC District Grievance Redressal Committee- Chaired by the DC District Level Convergence Committee - Chaired by the DC District Level Convergence Committee - Chaired by the DC

Organization Structure Karnataka State Rashtriya Swasthya Bima Yojana Society State Nodal Agency (SNA) Organization Structure Addl CEO 30 DKMAs ALCs/LOs Commissioner of Labour & Chairman Joint Labour Commissioner & CEO 176 Inspectors 30 District Coordinators 5 Managers

UHC Perspective Health beyond Health Care Going beyond a mere illness response Emphasize Prevention and Primary Health Care Access to every Indian Citizen (no bar on Income, Social Status, Gender, Caste and Religion) Promotive, Preventive, Curative and Rehabilitative Health Care Services Affordable, Accountable and Appropriate Health Care Services

RSBY & UHC RSBY is currently a response to illness and has a potential to meet what is defined for UHC

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