Efforts must also be made to reduce the cost of inpatient care
at public facilities; this can be done in part by ensuring the
availability of basic drugs and supplies at first-referral hospitals.
Policy makers should continue to explore and support efforts to
provide financial protection through insurance mechanisms.
The Indian government and individual state governments are
indeed pursuing expansions in publicly funded (or subsidized)
coverage for rural populations as well as other vulnerable
populations. For example, in April 2008, the Government of
India launched the Rashtriya Swasthya Bima Yojana (RSBY).
This voluntary scheme targets the 300 million people who are
below the poverty line. In return for a premium of Rs. 30 per
person per year, coverage is provided for hospitalization (either
at public or private facilities), capped at Rs. 30 000 per family
per year (Bhattacharjya and Sapra 2008). The balance of the
premium, Rs. 750 per person per year, is to be borne by central
and state governments. By the end of 2009, almost 9 million
households were enrolled in the scheme (Ministry of Labour
and Employment, undated) though this still represents a tiny
proportion of the target population.