Government committed to pay market rates for treatments under NHPS


According to NITI Aayog member Dr. Vinod Paul, the government is committed to the bear the cost of the National Health Protection Scheme (NHPS) irrespective of the market price of various procedures. While the government is planning to spend about Rs.1,000 to Rs.1,200 on premium per family, the actual cost per cover can be determined only after insurers start bidding on the scheme.


He noted that the premium cost per family will be shared between the Central and State governments on a 6:4 ratio. The total annual cost estimated for this scheme is around Rs.10,000 crore to Rs.12,000 crore. Most industry experts and analysts were of the opinion that the premium price per policy could be twice the amount estimated by the government.

Dr. Vinod Paul also stated that about 25 states have come aboard this scheme so far. About half of the states will implement the NHPS in the ‘insurance’ model, while the rest will implement it in the ‘trust’ model. The ‘trust’ model involves claim settlement through the creation of a corpus with contributions from the Centre and the State.

Most private hospitals empanelled under the plan stated that the government’s allocation for various treatment packages is significantly lower than the market rates. The Indian Medical Association (IMA) termed the package rates as unacceptable. The Association of Health Providers of India (AHPI) also asked the government to reconsider the package rates set for various medical procedures.

The IMA and AHPI were of the opinion that lower package rates will significantly bring down the quality of healthcare offered under this scheme. If the quality of treatment declines, it would affect the poor people enrolled in this scheme. Following these concerns, Dr. Vinod Paul said that the government will take these concerns into consideration.

The NHPS proposed by the ruling government goes by the name of Ayushman Bharat. This is an ambitious program that focuses on providing free health insurance coverage to nearly 50 crore individuals belonging to 10 crore families in the country. Under this scheme, each family will get health insurance coverage for Rs.5 lakh on a family floater basis.

Source: Financial Express


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