Notwithstanding the audacity of the Odisha Government’s announcement to launch the Biju Swasthya Kalyan Yojana (BSKY) touted as ‘Naveencare’ by junking the Ayushman Bharat billed as ‘Modicare’, the fact is the State has to bear a huge financial burden owing to the new move.
Moreover, risks are more for the State as post the launch of ‘Modicare’, ongoing Centrally sponsored health insurance schemes like the Rashtriya Swasthya Bima Yojana (RSBY) would cease to exist.
The result is a State not implementing Ayushman Bharat has to incur expenses for the scheme from its own resources. Also, the State would lose financial support under ‘Modicare’ that is intended to bring up infrastructure for health and wellness centres at PHC level.
Now, consider the arithmetic. Under the RSBY, the cover for health benefit is Rs30,000, though the State has enhanced it to Rs1lakh. And the annual premium per family is mere Rs750.
As the Centre and State’s share under the RSBY for Rs30,000 cover are in proportion of 60:40, the average premium (average of 30-districts) the State Government bearing then works out at around Rs300. As the State has enhanced the cover to Rs1lakh, it’s bearing the extra burden of Rs450 per family from its own resources.
While the Centre is providing around Rs201crore towards the annual premium expenses under the RSBY, the Odisha Government was bearing an expense to the tune of around Rs134 crore towards annual premium. Since the RSBY would cease to exist post ‘Modicare’, Odisha would stand to lose the Rs201crore from the Centre. Significant here is when target under the RSBY was around 61.6 lakh families, actual beneficiaries since launch till 2017 end were around 45 lakh only.
As health insurance cover is now enhanced to Rs5lakh, the annual premium then would stand hiked anywhere between Rs1,200 to Rs2,000 per annum per family, predict insurance actuaries here. They add it is unclear whether ‘Naveencare’ would cover pre-existing illness condition as announced under ‘Modicare’.
Annual premium gets higher if age-profile is over 40 years and if pre-existing health condition included then for Odisha the premium could cost Rs2,000. Private individuals now pay out around Rs3,500 – Rs5,000 premium for Rs5 lakh health cover.
Even, the annual premium charged by PSU National Insurance Company is around Rs14,000.
Assuming that the premium towards Rs5lakh cover will be between Rs1,200 and Rs2,000, the financial burden then on Odisha works out at a whopping Rs840 – 1,400 crore per year.
This is a huge sum and implications on the State Budget are quite conspicuous. How worth is the impact could well be ascertained from the fact that in 2018-19 Budget, the total health allocation under both revenue and capital expenditure for the State Plan, Centrally Sponsored Schemes and Central Plan was around Rs3,000 crore.
This means fund for ‘Naveencare’ alone in 2018-19 would be around 28-47 per cent of total plan expenditure on health, which is a very huge amount.
And the State Budget has no allocation for it. The Government could allocate only in the Supplementary Budget during Winter Session. Also, this seems no walkover for State Finance Minister Sashi Bhushan Behera when the amount needed for ‘Naveencare’ would be around 2-3 per cent of total expenditure on the State Plan during 2018-19.