Lessons India teaches the world
How do you develop a patient centred healthcare system that serves vast numbers of transient poor people? India has an answer: Rashtriya Swasthya Bima Yojna (RSBY), which has won plaudits from the World Bank and the United Nations as one of the world's best health insurance schemes. RSBY combines state-of-the-art technology and incentive structures. It is paperless, does not use cash and provides affordable health insurance to millions of people. The overwhelming majority of who, are illiterate, transient people living below the poverty line. According to Dr Anshuman Kumar, Chief Oncosurgeon, Dharamshila Cancer Hospital and Research Centre in New Delhi,
“Since its launch, four years ago, Rashtriya Swasthya Bima Yojna covers some 40 million people many of whom have benefitted from in-patient hospital procedures. The scheme has been so successful that the Government is planning to extend it to India’s old age and disabled pension schemes”.
In developing countries, poverty and ill health are synonymous. Billions of poor people lack access to healthcare while being exposed to multiple health risks. This, not only increases the health consequences for those individuals and their families, but has both a direct and indirect effect on economies. Widespread poverty as well as ill health decreases productivity; lowers competiveness, increases fiscal pressure, creates further poverty and promotes greater inequity.
India is a rising global economic superpower with a GDP roughly equivalent to 3% of the world economy, but has a third of the world’s poor. In 2011 the World Bank reported that 33% of India’s population fell below the international poverty line of US$1.25 per day and 69% live on less than US$2 per day. Although India is on track to meet its poverty reduction goal set by the United Nations in 2000; by 2015, 53 million people are expected to be still living in extreme poverty and 24% of India’s population of 1.2 billion is expected to be still living on less than US$1.25 per day.
India is not unique in being a rich country with poor people. This is a phenomenon shared by several developing countries. For example, Mozambique, rich in gas, oil and minerals, is a fast growing rich country with poor people. Ninety nine per cent of Mozambicans are small scale farmers and a large proportion of these are poor. Mega projects, such as the planned US$6 billion investment by Vale, a Brazilian company, to create the world’s largest coal mine in Mozambique, do not generate large numbers of jobs, do not foster entrepreneurship and because of the tax incentives they receive, only make modest contributions to exchequers. African rich countries with poor people might do well to look to India’s RSBY health insurance scheme.
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