Universal Health Care For People of BIHAR: Million Lives/Billion Wishes
Vivek Kashyap*
Providing Affordable Universal Health Care for its citizens has been the dream of each and every progressive society in the world. Many countries have worked towards it. Our country, too is no exception.
We have Yeshasvini Scheme from Karnataka for the rural poor, which happens to be one of the largest such schemes in the world. It also happens to be the biggest self funded scheme in the world. The person behind Yeshavini is Dr Devi Shetty, the founder of Narayan Hryudyalaya and needs no further introduction.
Bihar, too can learn a lot from this scheme, and can launch a modified version , well suited to its entire population of approx 11 crores. Bihar State’s entire population can be broadly divided into two groups- Lower Middle Class comprising poor families and the Middle Class comprising, Professionals, State Govt employees , Teachers, Lawyers, and employees from Public and Private Sector employees and Business Community.
The first group can be catered by a scheme similar to Yeshasvini scheme, where the premium is too low and the coverage amount is Rs 2 Lacs. In contrast the coverage under RSBY Scheme (a Central Govt Scheme) is Rs 30000/ only. The best part is Dr Shetty is approachable and will be more than willing to guide the State Govt to launch a pro poor health coverage scheme for Bihar.
The only precondition for launching such a low premium health care scheme is having a large population/ Customer base. Large number participation ensures low premium and equal distribution of risk. This can be tackled by creating awareness and advertising it amongst the target group. Here the elected representatives from Legislative Assembly to Gram Panchayat and bureaucracy from Secretary level to Block Development Officer- every one can play a big role.
In fact once any scheme becomes a Community Owned scheme in true sense, it becomes a success. The seven resolves of Bihar, better known as Nitish Nishchay too should be co owned by the bureaucracy and the elected representative in the similar fashion.
Having taken care of the first group, we can move to the second group-the Middle Class. This group too is highly neglected. It is no surprise that we don’t have a Health Insurance scheme for our State Govt employees. They do get reimbursement [IT IS NOT CASHLESS] but then the process is too cumbersome and once they retire and are more vulnerable they cease to enjoy the benefit of reimbursement.
On the other hand, Central Govt employees are a bit privileged.
We have a Central govt Scheme-CGHS but it covers only the Central Govt employees and Members of parliament as well Hight Court and Supreme Court Judges. The members of State Legislative Assemblies don’t get benefit of CGHS.
We have a huge number of Teaching Faculty and equally high number of Advocates who are highly vulnerable in absence of Health Insurance Coverage. It is about time for our State Govt took note of this fact and thought of a similar scheme for its Middle Class. This will not only create a social welfare scheme for the citizens, it will also result in massive good wishes for the state govt. Here again, a basic requirement would be having a decent good number of people to be enrolled, if we need a Low Premium with attractive features. The best part is that for this group, which is educated and cohesive, finding numbers is quite easy. We have approx 70 Lacs Consumers of Electricty in our State. To begin with, we can approach this group with a Group Health Insurance Scheme.
If State Govt is unable to devise a scheme for this group, any Insurance Company can take the lead and can approach this group. Let me repeat I am talking about a 70 Lac+ Strong Group which given a chance would take a Family floater Policy and this means we would end up covering approx 3 Crore People of our State- almost 30 % of State’s population.
It is a win-win situation for everyone. Insurance Company gets a HUGE NUMBER of Customers, Customers get higher coverage with lower premium and State Govt gets all the Good wishes of its people.
For such a huge customer base any Insurance Company will be more than willing to come up with attractive Health Insurance Scheme. A small committee from State Govt with technical expertise can be involved in discussion with leading Public Sector General Insurance Companies to thrash out a suitable scheme.
Andhra Pradesh has already taken a lead in Universal Health Coverage by announcing a number of Health Insurance Schemes for its residents. It has a Scheme for BPL Families. It has a separate scheme- Employee Health Scheme for State Govt Employees, separate Health Scheme for Journalists and has recently launched a Health For All scheme for Rs 100/a month which covers the entire family.
It is high time Bihar did something on similar lines for its residents. In fact, based on past supportive experience, Bihar can even try to rope in Bill Gates as well for this noble cause.
What is needed is only a “Firm Resolve” to get a Health Scheme rolled out covering the entire population of Bihar. And Nothing less than “Nitish Resolve” will do.
