Characteristics of the Scheme
1. In T. Narasipura Taluk, the seven public health facilities that were to be involved in the insurance scheme: a general hospital of T. Narasipura, 2 CHCs (one in Bannur and the other at Talakkadu) and 4 PHCs (at Kaveripura, Mugur, Malangi and Gargeswari), were improved by carrying out some administrative reforms. It was not much of a problem since the Government of Karnataka was also one of the agencies involved in the partnership.
2. The NIC offered the following insurance package. The premium charged was Rs 30 per person per annum. In the event of hospitalisation, insurance company would pay Rs. 100 per day per patient (Rs. 50 per day given directly to the NGO for drugs and Rs. 50 per day given to patient for loss of wages) with the maximum cover of Rs. 2,500 for all inpatient care at public health facilities. There were neither any exclusions nor any waiting period involved. Cases referred to other public hospitals were also covered under the scheme .
3. The premium was subsidized fully for BPL Scheduled Caste/Scheduled Tribe (SC/ST) population, partially (1/3rd amount i.e., Rs. 10) subsidized for BPL non-SC/ST family, and not subsidized for above poverty line (APL) families. In case of BPL SC/ST, family as a whole is a unit. In case of non-SC/ST BPL, individual is a unit of insurance.
4. Of Rs. 100 given to a member patient per day, fifty rupees meant for drugs were given to the NGO. With this money the NGO helped the patients buy medicines that were either not available with the health facility or were too expensive.
5. This way the NGO pooled the funds available to it for drugs. Not all member patients needed medicines worth Rs. 50, and some who did were helped though this fund. Thus, the patients needing less-value drugs cross-subsidized those who need costlier medicines. The NGO was the agency carrying out this cross-subsidy mechanism.
6. Two project implementation committees were formed : one at district level and the other at Taluk level. The former was headed by CEO of Zilla Panchayat and the latter by the Executive Officer of Taluka Panchayat. Orientation-cum-training sessions were organized for government officials and medical officers in the project areas. Staff members were trained.
7. Orientation and awareness generation programs were held for community leaders, Gram Panchayat members and chieftains who command influence in their respective areas.
8. Information, Education and Communication (IEC) activities that were carried out included : display of posters and hoardings at prominent public places, wall paintings, group meetings, Gram Panchayat level meetings of elected representatives, films shows using video tape prepared by NIC, announcements through loudspeakers, distribution of pamphlets, SHG members spread message by personally meeting the villagers.
In addition to paying full premium for covering SC/ST and partial premium for covering non-SC/ST population, UNDP provided funding for equipment (a wireless set) and administration (salaries of social workers and a coordinator). Centre for Population Dynamics (CPD) did the initial baseline survey, monitoring, end-line evaluation. UNDP funded these activities but the funding was routed through KT.
