1. 13.06.2016 Seite 1 Social Protection in India – Recent Initiatives and Role of GTZ Dr. Nishant Jain 22.11.2010

2. 13.06.2016 Seite 2 Page 2 Providing Social Security to Unorganised Sector Workers  Unorganised Sector Workers Social Security Act 2008  Employment Security – National Rural Employment Guarantee (NREGA)  Old Age Security – Old Age Pension Scheme and New Pension Scheme (NPS)  Life and Disability – AABY and JBY Schemes  Health and Maternity Security – Rashtriya Swasthya Bima Yojana (RSBY)

3. 13.06.2016 Seite 3 Page 3 GTZ Programme on Social Protection  Main Partner  Ministry of Labour and Employment, Government of India  Other Partners  Department of Financial Services, Ministry of Finance  Pension Fund Regulatory Development Authority  Depart of Insurance, Ministry of Finance  Programme Period – Six Years (First Phase of three years)

4. 13.06.2016 Seite 4 Page 4 Main Components  Support successful implementation of the Unorganised Sector Workers Social Security Act which includes:  Social Health Protection – RSBY  Life and Disability Cover  Old Age Protection  Convergence between different initiatives  Focus Areas  Capacity Building  Communication and Awareness  Policy level advise  Research and Evaluation

5. 13.06.2016 Seite 5 Page 5 Current Activities - RSBY  Health Insurance for Below Poverty Line population was started by Government of India in 2008 called Rashtriya Swasthya Bima Yojana (RSBY)  Focus is on shifting from supply side financing to a demand side financing mechanism  Other objectives are  Strengthening Public Health Care by bringing competition and incentives  Reduce OOPE on health care  Improve Quality of Care provided  Perhaps for the first time scheme was designed keeping in mind the characteristics of the beneficiaries who are  Poor  Illiterate  Migrant

6. 13.06.2016 Seite 6 Page 6 Current Activities - RSBY  RSBY is a Health Insurance Scheme for inpatient cover and some other benefits like transport allowance  It is a Public Private Cooperation model whether Government pays the premium to the Insurance Companies on the behalf of the beneficiaries  Each beneficiary family is issued a biometric smart card in the village  Beneficiary can go to any empanelled public or private hospital across India

7. 13.06.2016 Seite 7 Page 7 Enrollment Station

8. 13.06.2016 Seite 8 RSBY – The Beginning

9. 13.06.2016 Seite 9 Page 9 Current Status of RSBY Implementation in India  Cards issued – App. 21 Million  People enrolled – App. 83 million  Number of People benefitted till now – App. 1.1 million  Number of Hospitals Empanelled – App. 6500  States where Service delivery has started – Twenty three  Number of Insurance Companies Involved – Eleven

10. 13.06.2016 Seite 10 Page 10 Performance of RSBY in Districts which finished One year Number of Families enrolled10,487,131 Number of States (Districts)17 (140) Total Premium PaidUSD 130 million Enrollment Conversion Ratio51% Male Members in Enrollment63.50% Female Members in Enrollment36.50% Male members in Hospitalisation58% Female Members in Hospitalisation42% Hospitalisation Ratio3.10% Male Hospitalisation Ratio2.94% Female Hospitalisation Ratio3.63% Average Claim Ratio90.50% Average Claim SizeUSD 84.5

11. 13.06.2016 Seite 11 Page 11 Results So Far  In just two years studies have shown that RSBY has been able to:  Improve access to health care  Reduce out of pocket expenditure on health  Develop competition between public and private hospitals  Incentivise private sector to set up hospitals in interior rural areas  Provide a social identity  Reduce leakages and improve transparency in delivery

12. 13.06.2016 Seite 12 Page 12 Going beyond BPL  RSBY is being extended to other categories of Unorganised sector workers who are non-BPL  Building and Construction Workers  NREGA beneficiaries  Contractual Postmen  Railway coolies and Hawkers  Domestic workers  In many of these categories people have agreed to pay part or full premium by themselves  Last week Government of India has decided to open RSBY for APL also which means that any group which is ready to pay the premium can join the scheme

13. 13.06.2016 Seite 13 Page 13 Lessons for other Countries  Countries in South Asian, South East Asian and African region are interested in learning from the experience of RSBY  Some countries are interested in the health insurance system overall while some others are more interested in the Technology including the Smart Card  Countries like Pakistan, Bangladesh, Nepal, Maldives, Nigeria, Cambodia and Indonesia are planning to visit India early next year for further discussions

14. 13.06.2016 Seite 14 Page 14 Implication for other SP Initiatives  RSBY has provided a transparent smart card based platform in India which can be utilised for delivery of many other entitlement based Social Protection schemes which are targeted at same population  Discussions are going on to see how RSBY smart card platform can be used for:  Public Distribution System  NREGA  Life Insurance Schemes  This has also necessitated the need for the convergence between different Government schemes

15. 13.06.2016 Seite 15 Thank You nishant.jain@gtz.de