Health schemes
1. Rashtiya Swasthiya Bima Yojana (RSBY)
• Rashtriya Swasthiya Bima Yojana (RSBY) has been launched by Ministry of Labour and Employment, Government of India to provide health insurance coverage for Below Poverty Line (BPL) families.• The objective of RSBY is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization. Beneficiaries under RSBY are entitled to hospitalization coverage up to Rs. 30,000/- for most of the diseases that require hospitalization.
• Government has even fixed the package rates for the hospitals for a large number of interventions. Pre-existing conditions are covered from day one and there is no age limit. Coverage extends to five members of the family which includes the head of household, spouse and up to three dependents.
• Beneficiaries need to pay only Rs. 30/- as registration fee while Central and State Government pays the premium to the insurer selected by the State Government on the basis of a competitive bidding.
• Unique Features of RSBY
- Empowering the beneficiary– RSBY provides the participating BPL household with freedom of choice between public and private hospitals and makes him a potential client worth attracting on account of the significant revenues that hospitals stand to earn through the scheme.
- Business Model for all Stakeholders– The scheme has been designed as a business model for a social sector scheme with incentives built for each stakeholder. This business model design is conducive both in terms of expansion of the scheme as well as for its long run sustainability
- Insurers– The insurer is paid premium for each household enrolled for RSBY. Therefore, the insurer has the motivation to enroll as many households as possible from the BPL list. This will result in better coverage of targeted beneficiaries.
- Hospitals– A hospital has the incentive to provide treatment to large number of beneficiaries as it is paid per beneficiary treated. Even public hospitals have the incentive to treat beneficiaries under RSBY as the money from the insurer will flow directly to the concerned public hospital which they can use for their own purposes.
- Intermediaries– The inclusion of intermediaries such as NGOs and MFIs which have a greater stake in assisting BPL households. The intermediaries will be paid for the services they render in reaching out to the beneficiaries.
- Government– By paying only a maximum sum up to Rs. 750/- per family per year, the Government is able to provide access to quality health care to the below poverty line population. It will also lead to a healthy competition between public and private providers which in turn will improve the functioning of the public health care provider
- Information Technology (IT) Intensive – For the first time IT applications are being used for social sector scheme on such a large scale. Every beneficiary family is issued a biometric enabled smart card containing their fingerprints and photographs. All the hospitals empanelled under RSBY are IT enabled and connected to the server at the district level. This will ensure a smooth data flow regarding service utilization periodically.
- Portability– The key feature of RSBY is that a beneficiary who has been enrolled in a particular district will be able to use his/ her smart card in any RSBY empanelled hospital across India. This makes the scheme truly unique and beneficial to the poor families that migrate from one place to the other. Cards can also be split for migrant workers to carry a share of the coverage with them separately.
- Cash less and Paperless transactions– A beneficiary of RSBY gets cashless benefit in any of the empanelled hospitals. He/ she only needs to carry his/ her smart card and provide verification through his/ her finger print. For participating providers it is a paperless scheme as they do not need to send all the papers related to treatment to the insurer. They send online claims to the insurer and get paid electronically.
2. Central Government Health Scheme (CGHS)
• Central Government Health Scheme” (CGHS) provides comprehensive health care facilities for the Central Govt. employees and pensioners and their dependents residing in CGHS covered cities.
• CGHS was started in New Delhi in 1954, Central Govt. Health Scheme is now in operation in all major cities.
• Central Govt. Health Scheme provides comprehensive healthcare to the CGHS Beneficiaries in India. The medical facilities are provided through Wellness Centres (previously referred to as CGHS Dispensaries) /polyclinics under Allopathic, Ayurveda, Yoga, Unani, Sidha and Homeopathic systems of medicines.
• The main components of the Scheme are:
- The dispensary services including domiciliary care
- F. W. & M.C.H. Services
- Specialists consultation facilities both at dispensary, polyclinic and hospital
- level including X-Ray, ECG and Laboratory Examinations.
- Hospitalization
- Organization for the purchase, storage, distribution and supply of medicines and other requirements
- Health Education to beneficiaries
3. Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) aims at correcting the imbalances in the availability of affordable healthcare facilities in the different parts of the country in general, and augmenting facilities for quality medical education in the under-served States in particular. The scheme was approved in March 2006.
• The first phase in the PMSSY has two components - setting up of six institutions in the line of AIIMS; and upgradation of 13 existing Government medical college institutions. It has been decided to set up 6 AIIMS-like institutions, one each in the States of Bihar (Patna), Chattisgarh (Raipur), Madhya Pradesh (Bhopal), Orissa (Bhubaneswar), Rajasthan (Jodhpur) and Uttaranchal (Rishikesh) at an estimated cost of Rs 840 crores per institution. In addition to this, 13 existing medical institutions spread over 10 States will also be upgraded, with an outlay of Rs. 120 crores (Rs. 100 crores from Central Government and Rs. 20 crores from State Government) for each institution.
• In the second phase of PMSSY, the Government has approved the setting up of two more AIIMS-like institutions, one each in the States of West Bengal and Uttar Pradesh and upgradation of six medical college institutions namely Government Medical College, Amritsar, Punjab; Government Medical College, Tanda, Himachal Pradesh; Government Medical College, Madurai, Tamil Nadu; Government Medical College, Nagpur, Maharashtra, Jawaharlal Nehru Medical College of Aligarh Muslim University, Aligarh and Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, Rohtak.
• In the third phase of PMSSY, it is proposed to upgrade the following existing medical college institutions namely Government Medical College, Jhansi, Uttar Pradesh; Government Medical College, Rewa, Madhya Pradesh; Government Medical College, Gorakhpur, Uttar Pradesh; Government Medical College, Dharbanga, Bihar; Government Medical College, Kozhikode, Kerala; Vijaynagar Institute of Medical Sciences, Bellary, Karnataka and Government Medical College, Muzaffarpur, Bihar.
• It is hoped that consequent to the successful implementation of PMSSY, better and affordable healthcare facilities will be easily accessible to one and all in the country.
4. National AYUSH Mission (NAM)
• National AYUSH Mission encompasses core /essential activities on AYUSH Hospitals and Dispensaries services, development of AYUSH Educational Institutions covering under Graduate and Post Graduate educational institutes, ASU&H drugs quality control covering State Government ASU & HPharmacies, State Drugs Testing Laboratories, drugs control framework and promotion of Medicinal Plants.
• The basic objective of NAM is to promote AYUSH medical systems through cost effective AYUSH services, strengthening of educational systems, facilitate the enforcement of quality control of Ayurveda, Siddha and Unani & Homoeopathy (ASU &H) drugs and sustainable availability of ASU & H raw-materials.
• National AYUSH Mission (NAM) will address the gaps in health services through supporting the efforts of State/UT Governments for providing AYUSH health services/education in the country, particularly in vulnerable and far-flung areas.
• Under NAM special focus will be given for specific needs of such areas and for allocation of higher resources in their Annual Plans.
• The Mission will help in:
- the improvement of AYUSH education through enhancement in the number of upgraded educational institutions;
- better access to AYUSH services through increase in number of AYUSH hospitals and dispensaries, availability of drugs and manpower;
- providing sustained availability of quality raw material for AYUSH systems of medicine; and
- improving availability of quality Ayurvedic, Siddha, Unani and Homeopathy (ASU&H) drugs through increase in number of pharmacies, drug laboratories and improved enforcement mechanism of ASU&H drugs
5. Janani Suraksha Yojana
• Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission (NHM). It is being implemented with the objective of reducing maternal and neonatal mortality by promoting institutional delivery among poor pregnant women.
• Janani Suraksha Yojana was launched in April 2005 by modifying the National Maternity Benefit Scheme (NMBS). The NMBS came into effect in August 1995 as one of the components of the National Social Assistance Programme (NSAP).
• Several initiatives have been launched by the Ministry of health and Family Welfare (MoHFW) including Janani Suraksha Yojana (JSY) a key intervention that has resulted in phenomenal growth in institutional deliveries
• Government of India has also launched Janani Shishu Suraksha Karyakaram (JSSK) on 1st June, 2011.
• The initiative entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery, including caesarean section.
• The entitlements include free drugs and consumables, free diet up to 3 days during normal delivery and up to 7 days for C-section, free diagnostics, and free blood wherever required. This initiative also provides for free transport from home to institution, between facilities in case of a referral and drop back home.
• The scheme aims to eliminate out of pocket expenses incurred by the pregnant women and sick new borns while accessing services at Government health facilities.
• The scheme is estimated to benefit more than 12 million pregnant women who access Government health facilities for their delivery. Moreover it will motivate those who still choose to deliver at their homes to opt for institutional deliveries.
6. National Tobacco Control Programme (NTCP)
• Tobacco use is one of the main risk factors for a number of chronic diseases, including cancer, lung diseases, and cardiovascular diseases. India is the 2nd largest producer and consumer of tobacco and a variety of forms of tobacco use is unique to India.
• Government of India launched the National Tobacco Control Programme (NTCP) in 2007- 08 in 42 districts of 21 States/Union Territories of the country.
• The Government of India has enacted the national tobacco-control legislation namely, “The Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003” in May, 2003.
• NTCP Objectives :
- To bring about greater awareness about the harmful effects of tobacco use and Tobacco Control Laws.
- To facilitate effective implementation of the Tobacco Control Laws.
- The objective of this programme is to control tobacco consumption and minimize the deaths caused by it.
• Cigarettes and other tobacco products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and distribution) Act, 2003
• Main Provisions of the Act
- Prohibition of smoking in public places. Implement from 2, Oct, 2008.in the hole of India.
- Prohibition of advertisement, sponsorship and promotion of tobacco products.
- Prohibition of sale of tobacco products near educational
institutions
- Regulation of tar and nicotine contents of tobacco products.
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