The Chhattisgarh government recently announced that it was shifting from an “insurance model” to a “trust model” in the field of healthcare and that as many as six insurance schemes run by the state government and the center would now be subsumed in a single new healthcare scheme, which would be run by the state government. The idea, the state government said, was to fix accountability on the state health infrastructure itself, and to lessen the amount of public money that was going to the private sector under the insurance model.

On November 15, after a meeting of the state cabinet, a press statement stated that the state was entering a “new phase of healthcare”. Accordingly, a new scheme — Dr. Khubchand Baghel Swasth Sahayata Yojana — will provide coverage up to Rs 5,00,000 per year to not only Pradhanmantri Jan Arogya Yojana families but also to Pradhmikta & Antoyaday Ration cardholders. The new scheme will increase the beneficiary family count from 42 lakhs to 56 lakhs families. “The scheme will be implemented in Trust mode (assurance),” the cabinet release said.

Health Minister TS Singhdeo told The Indian Express that the primary aim is to fix accountability on the healthcare system itself and to increase the financial efficacy of the department. “The job of the minister must be to increase delivery through the pyramid structure which has mitanins (who are the ground-level health workers) at the base and medical college doctors at the top… We took this up as a challenge on several fronts. One could be the financial aspect. Second is the better use of public funds. And the third is (the) deliverables,” he said. Singhdeo explained that the state had as many as six overlapping schemes where the services were being delivered. “What was being provided by one scheme was also being provided by two-three schemes, ” he said, claiming that this has been streamlined.

The minister also said that under the existing “insurance model” there were suspicions of misuse of funds. “In our system, we are fixing accountability on ourselves,” he said.

On the financial benefits the new scheme will accrue, Singhdeo said, “We have not asked for a paisa more than the Rs 845 crore that is the budget for the insurance schemes as well as Rs 277 crore from the Centre. This amount of money, where is it going? As we saw it, straight away 15 percent of public money was going into the administrative expenses of the insurance company. This was around Rs 100 crore. We want to minimize that. So within the same budget, we make a saving. Take on the responsibility to deliver and have the funds for strengthening your public infrastructure. Part of the 15 percent will go to the government’s administrative costs but it will not be more than half, so half you will be saving.”