As part of our ongoing initiative to launch a Joint Learning Network on Universal Health Coverage, R4D hosted Anil Swarup, the Director General for Labour Welfare and the Joint Secretary of India’s Ministry of Labour and Employment, to speak about India’s advance toward universal health coverage through the Rashtriya Swasthya Bima Yojna (RSBY) scheme. Representatives from the World Bank, IFC, PAHO, US State Department, Center for Global Development, and the USAID Health Systems 20/20 project attended the session, among others.

Targeting below-the-poverty-line (BPL) families, the RSBY program has enrolled over 45 million people in 26 Indian states since its inception in 2008; the scheme plans to cover the entire BPL population in India (approximately 300 million people) by 2012-2013. Each implementing state selects a private or non-governmental insurer based on a competitive bidding process, and the insurer is tasked with enrolling eligible beneficiaries, creating a provider network, and handling administrative functions.

In his presentation, Mr. Swarup explained how RSBY offers new solutions to the longstanding problem of extending coverage to hard to reach populations. RSBY has emphasized making the system simple to use and has built in incentives to ensure beneficiaries are enrolled and using available care. Using an innovative SmartCard system, RSBY has addressed many of the issues that previously prevented BPL families from accessing care, including illiteracy and the migrant nature of many informal workers. Mobile enrollment stations make the RSBY enrollment process possible in rural areas and streamline patient identification at clinics and hospitals in the RSBY delivery network.

Following Swarup’s presentation, a panel of health systems experts discussed the opportunities and challenges facing the RSBY system as well as its potential applicability to other countries in the midst of health financing reforms. Dr. Julie Hudman commented on India’s unique ability to build a program from the ground up and the associated opportunities in institutional structure, technology and administration. Dr. Leonardo Cubillos discussed lessons that can be learned from RSBY in how to build awareness among the hardest to reach populations and effectively identify, target and enroll them. Dr. Alex Preker outlined several challenges that lie ahead for RSBY, including managing private insurers, ensuring quality in service delivery, and sustainably and strategically taking the program to scale.

To learn more about the details of the RSBY scheme, click here to read the full case study prepared for the Joint Learning Workshop: Moving Toward Universal Health Coverage.

_{Mr. Anil Swarup is the Director General for Labour Welfare and the Joint Secretary of Labour and Employment for the Government of India. Mr. Swarup handles issues related to the welfare of unorganized sector workers. He is the founder of RSBY, the National Health Insurance Program currently targeting low-income families, and is responsible for overseeing its implementation across India on a state-by-state basis. Mr. Swarup previously served in a number of other positions for both the Government of India and the State Government of Uttar Pradesh. Included among Mr. Swarup’s previous positions are Managing Director of the State Financial Corporation (Uttar Pradesh), Secretary of Externally Aided Projects (Uttar Pradesh) and Export Commissioner for the Ministry of Commerce (Government of India).}

_{Dr. Julie Hudman is first Director of the Department of Health Care Finance (DHCF) for the District of Columbia. As Director, Dr. Hudman oversees a more than two billion dollar budget which includes the District’s Medicaid program, the Children’s Health Insurance Program (CHIP) and a wide range of locally funded health care programs. Prior to assuming responsibility for DHCF, Dr. Hudman served as the Program Manager for Health and Human Services in the City Administrator’s Office within the Executive Office of the Mayor. Over the course of Dr. Hudman’s twenty year career, she has held senior positions in health policy, worked in state agencies, and consulted for providers and universities. She began her extensive health policy career in state health programs -- working at the state level in Oklahoma, Massachusetts and Rhode Island.}

_{Dr. Leonardo Cubillos is a Consultant for the World Bank Institute. Prior to joining World Bank Institute, Mr. Cubillos was Director General of Demand Management (Insurance) and Acting Viceminister at the Ministry of Social Protection in Colombia. He led a team responsible for the Direction and Regulation of the Subsidized Regime that insures 23 million Colombians, and was also responsible for designing, implementing and monitoring policies that reached 43 million citizens in regards to the benefits plan and contracting and payment mechanisms for both insurers and providers. Mr. Cubillos and his team designed and implemented a rigorous and systematic plan to update and cost the benefits plan and, at the end of his work in the MPS, the Subsidized Regime achieved Universal Health Insurance Coverage.}

_{Mr. Alexander Preker is Head of the Health Industry Group and Health Investment Policy Analysis for the Investment Climate Department of the World Bank Group. He leads a team of advisors and analysts that work with policy makers, investors and health businesses in improving the market environment for private sector participation in the health sector in developing countries. Mr. Preker has had a distinguished career, working at different times for World Bank, International Finance Corporation (IFC) and World Health Organization (WHO). Previously, as Chief Economist for the health sector, he coordinated the technical team that prepared the World Bank’s Health, Nutrition and Population Sector Strategy in 1997. Mr. Preker has published extensively and is a frequent speaker at international events. He coordinated the team that prepared the World Bank's Sector Strategy for Health, Nutrition and Population in 1997. While working with the World Health Organization in 1999-2000, he was one of the coauthors of the World Health Report 2000 Health Systems: Measuring Performance.}

Attached File(s): 

RSBY Case Study.pdf