With the Union cabinet giving its nod to the recently announced National Health Protection Scheme (NHPS)—aimed at protecting 100 million poor and vulnerable families against hospitalisation expenses—some design elements of the scheme are known now. For example, the scheme will cover pre-existing diseases, will allow for portability of insurance cover, will cover pre-hospitalisation and post-hospitalisation expenses to some extent, and provide for cashless hospitalisation. These are all sound design elements. One of the important issues relates to the choice of implementing agency. Broadly, there are two options to choose from: (i) create an independent, not-for-profit, trust that manages the scheme and (ii) let a formal insurance company operate the scheme.
conclusion: NHPS, without doubt, is a game changer not only in terms of elevated ambitions for providing financial protection against hospital costs, but also for carrying out key reforms in the Indian healthcare system. But, getting it right is important for the realisation of its full potential. For this, it is important to also understand path-dependencies that each of the options would create. Hopefully, the policymakers will also study these dependencies objectively, and not let the more vocal and organised voices sway the foundational decision about the choice of the implementing agency.
