India:health & social security

The Indian Government has succeeded in the mammoth task of setting up a health insurance scheme that covers half a billion people – making it a positive example for other countries. GIZ is providing support on behalf of the German Government. Launched in 2018, the health insurance scheme is known as PM-JAY and roughly translates into English as the prime minister’s health scheme for the people. It targets people who have inadequate or no social health protection: poor and disadvantaged people, especially those working in the informal sector, who account for 80 per cent of India’s working population. Besides day labourers, they include taxi drivers and people working in the retail trade.

PM-JAY entitles every registered family to use health care services in hospitals for the equivalent of up to EUR 6,300 per year. People can enrol easily right at the hospital by presenting identification. It is free of charge for families. Almost five million hospital treatments were funded by PM-JAY in its first year. Around 20,000 hospitals are part of the system’s network, which is already active almost everywhere throughout the country. PM-JAY is a project that evolved over time, kicking off in 2008 with the Indian Government’s national health insurance scheme. GIZ was involved from the outset and has been running the Indo-German Social Security Programme since 2011. This programme was commissioned by BMZ and has been cofinanced by the Bill & Melinda Gates Foundation since 2017.

PM-JAY has now become the world’s largest completely government-funded health insurance scheme. Its previous incarnation already served 134 million people; its scope has now widened to 500 million beneficiaries. Reaching this massive number would be impossible without digital tools. That’s why GIZ is also providing IT advice. The digital building blocks of the insurance scheme include online enrolment for insured people and hospitals, billing insurance services and automatically identifying irregularities in the invoicing system. Once registered, beneficiaries receive a print-out confirming that they are insured. It has a QR code that they can use to be identified straight away the next time they go to hospital. PM-JAY has created a modern health care system that reaches an unprecedented number of people.