Vajpayee Arogyashree Scheme (VAS) has lowered both mortality rates and out-of-pocket expenses for the people of Karnataka, according to an evaluation published in the health journal The BMJ.
VAS is a government programme to provide health insurance against major illnesses to below-the-poverty-line (BPL) households in the State. It is implemented by the State government with World Bank support.
Out-of-pocket health expenditures for hospitalisations due to the covered conditions have dropped by 60 per cent, the study said and added that use of healthcare facilities for the covered conditions may have risen.
“This World Bank study clearly shows how this programme benefits the poor in Karnataka,” said U T Khader, Karnataka Minister of Health and Family Welfare. “It provides hospital care that the poor would have difficulty receiving without the help of the scheme.”
The free insurance covered specific high-impact medical conditions – such as heart disease and cancer – which poor residents often die from because they are unable to pay for the expensive treatments.
Benefits to the poor Some of the unique features of the VAS programme includes free tertiary care at both private and public hospitals empanelled by VAS for BPL families; automatic enrolment of all BPL families with no annual premiums, user fees, or co-payments; and health camps in rural areas by empanelled hospitals, which helped screen patients for tertiary care and transport them to hospitals in urban centres.
“The results of this study are important to India as it makes choices on how to make progress towards universal health coverage,” said Onno Ruhl, World Bank Group Country Director for India.
“The programme shows how purchasing health services for the poorest can both improve health and provide protection from impoverishment due to out-of-pocket payments for health care,” he added.
Wide coverage The evaluation included more than 82,000 households. Since the programme was phased, covering poor households in the northern part of Karnataka in the first phase before expanding to the rest of the State, the study compared the health outcomes of roughly 45,000 households from villages that were covered by the insurance to roughly 37,000 households from villages that were not covered by the programme.
The study was funded by the World Bank Group’s Health Results Innovation Trust Fund. The co-authors of the study were Eran Bendavid from Stanford University, Arnab Mukherji from the Indian Institute of Management, Bangalore, Zach Wagner from the University of California, Berkeley, and Patrick Mullen and Somil Nagpal from the World Bank Group.