Assessing Impact of India’s National Health Insurance Scheme (RSBY): Is There Any Evidence of Increased Health Care Utilisation?
Rajesh Kumar Sinha, Keya Chatterjee

Abstract
Providing quality health care to all is a policy commitment India made by becoming a signatory in the Alma Ata declaration. India is working towards providing Universal Health Coverage through its National Health Policy.However, to achieve this goal; it needs to reach out to the poorest and the mostvulnerable sections of the society, andmake available affordable health care to them. Rashtriya Swasthya Bima Yojana (RSBY) is a step in this direction that insures these families for a minimum sum, to increase their access to health care and protect against catastrophic health expenses. This paper has tried to analyse if the insurance instrumentsincluding RSBY have been able to increase health service utilization in the country, especially by the poorest quintiles of the population. The findings from NSSO data,for the states which have completed minimum three years of RSBY implementation, compared for the year 2011-12 against year 2007-08, the baseline year, shows no change in the health service utilization pattern.On the contrary, in some states, it is showing a negative trend. The analysis also shows that the expenditure for outpatient treatment has a substantially high share of the overall household expenditure, and could actually be catastrophic for resource poor families. Such expenditures being left out of the ambit of RSBY is a matter of concern.

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