State governments have started contemplating on the recently launched National Health Protection Scheme (NHPS), touted as Modicare, as the Centre seeks information from each state over its implementation
The Ministry of Health and Family Welfare (MoH&FW) along with Niti Aayog have consulted all the state governments to set up a mechanism and discuss details about implementation of NHPS. This is to assess their preparedness and learn from the states which have had a good experience in implementing their own health insurance and assurance schemes.
According to MoH&FW, the background notes and concept paper of the scheme was shared in advance with all the states. 31 states and Union Territories participated in the two-day deliberations along with representatives from MoH&FW, Ministry of Finance, NITI Aayog and other stakeholders.
According to a statement issued by MoH&FW, most of the states were represented by officials at the level of Additional Chief Secretary, Principal Secretary, Secretary of Health. The two-day consultations were attended by more than 200 participants. The programme was to engage with states to finalise the contours of the scheme. Six working groups were formed.
Informing that the working groups had detailed deliberations based on the experiences of implementing Rashtra Swasthya Bima Yojana (RSBY), implementation of the states’ own schemes and global experiences, the MoH&FW informed that the best practices for each of the process related to beneficiary identification, hospital empanelment, hospitalisation services, grievance redressal mechanisms, IEC activities etc., were identified from each state and recommendations were presented by each working group to the ministry. The States had shared the current challenges being faced and potential solutions were shared with them.
The statement added that on the second day of national consultations, five groups of states were formed based on the implementation status of health insurance schemes: States with only RSBY, states with RSBY and their own schemes, states with only their own schemes in insurance mode, states with only their own schemes in trust mode and states with no health insurance/ assurance schemes.
NHPS Working Groups
The working group are set up to recommend on the details of various processes related to NHPS which will be incorporated in the broad operational guidelines proposed to be issued for implementing NHPS.
Working group on information technology
The working group was set up to recommend on the on Information Technology System/ Platform that will be used for effective implementation of NHPS.
Working group on fraud detection and grievances
The working was set up to recommend strategies to prevent and control potential frauds and abuse that may happen under the scheme. The group will also recommend mechanism for complaint and grievance redressal at each level under the scheme.
Working group on awareness generation
The working group was set up to recommend on the IEC and awareness generation activities that will need to be carried out for implementation of NHPS.
Working group on institutional arrangement
The working group will need to recommend on the institutional arrangement that will need to be carried out for implementation of NHPS.
Working group on continuum of care
The working group was set up to define the scope and range of the continuum of care approach such that when NHPS evolves over the years, the direction of this growth is pre-defined.
Each of these five categories of states identified the issues and likely solutions. Bilateral meeting was held by Secretary Health and Member Health NITI on the preparedness of the states to integrate and operationalise the scheme.
Concurrently, the state government representatives were uncertain about the pattern of NHPS. While several state health officials informed that the state’s budget allocations for the financial year is already done, with the NHPS they are asked to provide extra budgetary allocations for the scheme.
Speaking to Express Healthcare, a Principal Secretary, representing a southern state, pleading anonymity informed, “The Centre and Niti Aayog has given two options to decide on the trust or insurance mode of implementing the scheme. We have been asked to give Aadhaar-seeding socio-economic caste census (SECC) data for targeted families and organising gram sabhas, finalise insurance companies and empanelling hospitals in and around three to four months.”
Many state government have raised question on why they should switch to NHPS.
Speaking at a public meeting recently, Mamta Banerjee, Chief Minister, West Bengal, informed that the state has already made hospitalisation and medical treatment free for its citizens and sees no point in spending health plan and it will not waste its hard-earned resources in contributing to the programme.
Giving his opinion, Ramesh Kumar, Health Minister, Karnataka informed that the state would focus on its own universal health assurance scheme that would be launched at the end of the month.
Under the NHPS, the central government will contribute Rs 2,000 crores to the scheme out of a total cost of Rs 5,500-6,000 crores – the remaining amount is to be paid by the state governments.