Rajasthan leads the way in UHC

Amidst all the gloom and doom news of Covid-19 wave raging across the country and people gasping for oxygen, here is a breadth of fresh air. Rajasthan, the desert state in the western part of the country launched a Universal Health Coverage (UHC) scheme for all residents of the state. Announced in the budget speech for FY22 presented by chief minister Ashok Gehlot, who also holds the Finance portfolio, the state will offer cashless medical insurance of up to Rs.5,00,000/- to all families in the state. According to estimates, the population of Rajasthan is little over eight crores. The state has allocated Rs.3,500/- crores for the Mukhyamantri Chirajeevi Yojana, the official name of the scheme.

The scheme comes into effect from 1^st May 2021 and the following categories are eligible by default: Socio Economic Class Census (SECC) 2011 Registered families, National Food Security Act (NFSA) Card Holders, Small/Marginal Farmers, Contractual Workers. The scheme is completely free of cost to all the above categories. Whereas, the families, which are outside these categories can register themselves on the health ministry portal to be eligible for the health cover by paying an annual premium of Rs.850 and a one-time registration fee of Rs20. A comparison of the annual premiums for policy coverage of up to Rs.5,00,000/- for an individual alone on policybazaar.com shows that even for basic policies, the minimum premium is Rs.4,000/- plus. Moreover, these policies cover far less than what is proposed under Chiranjeevi Yojana. Thus, making it financially very attractive for families to sign-up for the scheme.

The Chiranjeevi Yojana will cover 1576 pre-defined medical conditions and Covid-19 care too. Unlike most of the health insurance schemes, which only cover in-patient expenses, the Chiranjeevi Yojana will also cover Out of Pocket Expenses (OOPE) on medical/diagnostic tests, other medical expenses and will also offer a related package of up to 15 days after getting discharged from the hospital. This move is like to significantly reduce the OOPE burden on families, which itself amounted to over 60 per cent of the total health care expenses and pushes millions of families below the poverty line, each year.

While the design of the scheme is grand and the policy thinking is in the right direction, the biggest challenge emanates from the limited medical infrastructure to support such initiatives. The execution will be the key. In addition, enough studies have in the past raised concerns over the excess/unnecessary consumption of medical services because of the availability of a financial cover paid by a third party. The challenge maybe even bigger as the scheme is cashless and there is very little incentive to keep the cost down, both for the patient and the caregiver. Nonetheless, the scheme will be closely watched not only in the state of Rajasthan but by other states and the Union government too for lessons on its success and challenges in replicating the model across the country. Until such a time, wishing that the residents of the state remain in the pink of their health.