Does Public Health System Provide Adequate Financial Protection to Its Clients Through RSBY? An Exploratory Study of Tribal Odisha

Abstract

This study estimates whether Rashtriya Swasthya Bima Yojana (RSBY) protects beneficiaries from out-of-pocket health expenditure arising at the time of illness and points out obstacles that the beneficiaries face. This article uses data of 100 beneficiaries selected through simple random sampling from the beneficiaries list that were collected from the district headquarter hospital of Mayurbhanj District, Odisha, India. This study highlights that only 8.4 per cent beneficiaries access their full healthcare services from the scheme. More than 50 per cent are forced to spend from their own pocket even though they have sum assured. The beneficiaries face problems like lack of awareness, no proper enrolment procedure, no cooperative hospital staff, limited assured money sanctioned per day, only inpatient care services, an unhygienic atmosphere in the hospital, long distance to the empanelled hospital and exploitation among health service providers. Awareness may be created among insured. The behaviour of healthcare providers may be turned friendly. Immediate attention may be provided by help desk counters to the beneficiaries. The sum assured amount may be increased. The detailed receipt of hospital expenditure may be supplied to the insured at the time of discharge.