(i) Making 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.
  • The number of forms people face to enrol in NHPS must be minimized. Aadhaar makes it easy to verify eligibility and enrol.
  • Once enrolled, access to care should be provided where people live. This is a challenge in rural India but can be addressed with innovative models. For example, In Karnataka, health camps organized by super specialty hospitals were successful in improving access to care.

 

(ii) Right targeting:

 

  • A programme financed by public money needs to conserve resources. Therefore, we should provide government sponsored insurance only to those who cannot afford insurance on their own.
  • In addition to targeting the poor, insurance should target health conditions where disease burden is high and effective interventions are available but underused.

 

(iii) Contracting 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 need to be part of NHPS. We thus need to monitor them and create the right incentives for them.
  • Not all hospitals should be eligible for NHPS. Only hospitals that meet certain quality standards should be allowed to serve NHPS beneficiaries.

 

(iv) Using 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.

 

(v) Sound financing and a strong data infrastructure are also important.

 

Any financing scheme must be backed by a strong data backbone, without which claims can’t be tracked and paid, and without which the plan will ultimately fail.

 

India must leverage its IT prowess to get the data backbone right. With programmes of this scale, roll-outs matter.

 

With an estimated 7% of India’s population pushed into poverty each year due to medical expenditures, NHPS intends to provide an essential safety net for the poor.

The government can learn from the lessons of RSBY to get NHPS’s implementation right. The health of millions of Indians depends on it.

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