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The National Health Protection Scheme

The National Health Protection Scheme

Context:

India recently announced an ambitious plan called the National Health Protection Scheme (NHPS) to provide government-sponsored insurance to roughly 500 million people or nearly 40% of India’s population.

Why NHPS is a good idea:

  • India under-invests in the healthcare of its citizens and this is affecting the health and financial well-being of Indians.
  • The NHPS should be considered a significant move towards universal health coverage. Health-financing policy directly affects the financial protection of people when direct payments that are made to obtain health services do not threaten their living standards.
  • While not all insurance programmes are successful, there is sufficient evidence that if implemented well, insurance can save lives and improve financial well-being.
  • The study conducted on the Vajpayee Arogyashree Scheme (VAS) of Karnataka found that VAS lowered mortality for covered conditions for BPL families and erased rich-poor disparities in mortality rates.
  • Existing evidence shows that providing insurance to the poor not only saves lives but is also “cost-effective”. It provides good value for money as the benefits of insurance far outweigh the costs.

Ensuring the success of the programme:

  1. Make insurance easy to use: Insurance that is difficult to use will not be used. Therefore, we need to streamline both the enrollment process and access to care once enrolled.
  2. Access to care should be provided where people live. This is a challenge in rural India but can be addressed with innovative models.
  3. Target low-income populations: The government sponsored insurance should be provided only to those who cannot afford insurance on their own.
  4. Contract with private hospitals and clinics: Nearly 75% of out-patient department care and 55% of in-patient department care in India is exclusively from the private sector. Therefore, private hospitals and clinics provide care to a large fraction of the population and they need to be part of NHPS.
  5. Use data to learn and evolve: The NHPS will have access to health information of 500 million people. This is an unprecedented amount of data and if curated well, it can have far-reaching applications. It can be used for comparative effectiveness research or understanding which treatments work in the real world rather than just in clinical trials.
  6. Tracking the NHPS will be extremely important to set priorities and shape future health policies in India. In a large and diversified country, health needs differ from state to state, and, within a state, can vary greatly from one district to another.

 

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