The health insurance scheme for unorganised workers launched by the Government of India holds the potential to effect a socio-economic change of far reaching significance. The Rashtriya Swasthya Bima Yojana (RSBY), launched formally last year, will provide coverage for the families of the unorganised sector workers below the poverty line. What distinguishes this from other social schemes is the application of user-friendly information technology. The scheme provides cashle ss health insurance cover up to Rs.30,000 for all the eligible families. The smart card, which provides for the cashless transactions, and can be used anywhere in the country, has the potential to open the doors of healthcare facilities to millions of the poor. It also offers a choice between public and private healthcare. The RSBY aims to cover an estimated six crore BPL families, at one lakh per district, over the next five years. The programme, which covers costs of hospitalisation for a range of illnesses, is bound to change the lives of poor workers who are outside the ambit of even minimal social protection by bridging gaps in access to healthcare facilities. Seen in the larger context of high out-of-pocket expenses for healthcare in India and the low incomes of the unorganised sector workers, the use of technology presages major changes in how India addresses social security.

Reaching the benefits of welfare schemes to the deserving people is one of the most problematic areas of development. The introduction of the smart card technology, together with other efforts to improve medical infrastructure, could be an effective way of addressing inequities in access to healthcare. There are caveats, however. For the successful implementation of the RSBY, built-in safeguards are as crucial as the manner in which state and private healthcare providers attune themselves to the new technology. For instance, measures are needed to curb the temptation of hospitals to resort to an overuse of medical tests, taking undue advantage of the insurance cover. In the long term, as the scheme takes root and the States share experiences, policy-makers could explore the possibility of extending the range of such welfare measures. As implementing welfare schemes gets easier with technological applications, it is equally important to check abuses and leakages that short-change the poor. Smart card technology, if used imaginatively, can help in the move towards meaningful social security, a goal that has so far proved elusive.