“When the Government Changes, the Card Will Also Change”: Questioning Identity in Biometric Smartcards for National Health Insurance (RSBY) in India

Authors

  • Stefan Ecks School of Social and Political Science, University of Edinburgh, Edinburgh, UK

DOI:

https://doi.org/10.3138/anth.60.1.t18

Keywords:

biometric IDs, RSBY, India, health insurance, poverty, consumer citizens

Abstract

Since the mid-2000s, government initiatives in India have been gripped by the idea that biometric identification is more efficient than any form of paper-based documentation. In this article, I explore how new health care schemes in India have adopted this technocratic promise. On the basis of ethnographic research in Karnataka, I describe how enrolments for biometric smartcards for RSBY insurance proceeds. These enrolments are meant to turn the rural poor into consumer citizens, yet the RSBY cards elicit unexpected responses from the beneficiaries. Instead of reproducing state authority, the new ID cards become a fulcrum for questioning the stability of government.

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References

Aggarwal, Aradhna. 2010. “Impact Evaluation of India's ‘Yeshasvini' Community-Based Health Insurance Programme.” Health Economics (19): 5–35. https://doi.org/10.1002/hec.1605.

Anjaria, J. S., & Rao, U. (2014). Talking back to the state: citizens' engagement after neoliberal reform in India. Social Anthropology, 22(4), 410–427.

Bhatia, Jagdish C., and John Cleland. 2001. “Health-Care Seeking and Expenditure by Young Indian Mothers in the Public and Private Sectors.” Health Policy and Planning 16(1): 55–61. https://doi.org/10.1093/heapol/16.1.55

Cohen, Lawrence. 2016. “Duplicate, Leak, Deity.” Limn 6. http://limn.it/duplicate-leak-deity/

Das, Veena, and Deborah Poole, eds. 2004. Anthropology in the Margins of the State. Santa Fe: School of American Research Press

Devadasan, Narayanan, Kent Ranson, Wim Van Damme, Akash Acharya, and Bart Criel. 2006. “The Landscape of Community Health Insurance in India: An Overview Based on 10 Case Studies.” Health Policy [Amsterdam] 78(2–3): 224–234. https://doi.org/10.1016/j.healthpol.2005.10.005.

Ecks, Stefan. 2005. “Pharmaceutical Citizenship: Antidepressant Marketing and the Promise of Demarginalization in India.” Anthropology & Medicine 12(3): 239–254. https://doi.org/10.1080/13648470500291360

Ecks, Stefan, and Ian Harper. 2013. “Public-Private Mixes: The Market for Anti-tuberculosis Drugs in India.” In When People Come First: Critical Studies in Global Health, ed. João Biehl and Adriana Petryna, 252–275. Durham, NC: Duke University Press. https://doi.org/10.1515/9781400846801-013

Economic Times. 2012. “German Delegation Coming to India to Take Rashtriya Swasthya Bima Yojana Lessons.” 12 August. http://economictimes.indiatimes.com/news/economy/policy/german-delegation-coming-to-india-to-take-rashtriya-swasthya-bima-yojana-lessons/articleshow/15367929.cms?intenttarget=no

Economic Times. 2016. “Government to Use Aaadhar to Deliver Benefits to Unorganized Workers.” 2 May. http://economictimes.indiatimes.com/news/economy/policy/government-to-use-aadhaar-to-deliver-benefits-to-unorganised-workers/articleshow/52077509.cms

Garg, C. C, and A. K. Karan. 2009. “Reducing Out-of-pocket Expenditures to Reduce Poverty: A Disaggregated Analysis at Rural-urban and State Level in India.” Health Policy and Planning 24 (2): 116–128. doi: 10.1093/heapol/czn046.

Gelb, Alan, and Julia Clark. 2013. “Identification for Development: The Biometrics Revolution.” Working Paper 315, Center for Global Development. https://www.cgdev.org/publication/identification-development-biometrics-revolution-working-paper-315. https://doi.org/10.2139/ssrn.2226594

Gelb, Alan, and Sneha Raghavan. 2014. “Rolling Out the Aadhar.” Center for Global Development, March 6. https://www.cgdev.org/blog/rolling-out-aadhaar.

Government of India. 2017. Rashtriya Swasthya Bima Yojana. http://www.rsby.gov.in/

Government of India. Ministry of Health & Family Welfare. 2014. National Health Policy 2015 Draft. http://www.mohfw.nic.in/showfile.php?lid=3014

Gupta, Akhil. 2012. Red Tape: Bureaucracy, Structural Violence, and Poverty in India. Durham, NC: Duke University Press. https://doi.org/10.1215/9780822394709

Hull, Matthew S. 2012. “Documents and Bureaucracy.” Annual Review of Anthropology 41(1): 251–267. https://doi.org/10.1146/annurev.anthro.012809.104953

Komarinski, Peer. 2005. Automated Fingerprint Identification Systems (AFIS). Amsterdam: Elsevier Academic

Indian Health Insurance Experiments. 2017. Indian Health Insurance Experiments. University of Chicago. https://indiahie-sites.uchicago.edu/

Karan, Anup, Wnnie Yip, and Ajay Mahal. 2017. “Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on Out of Pocket Spending for Healthcare.” Social Science & Medicine 181: 83–92. https://doi.org/10.1016/j.socscimed.2017.03.053

Kaur, Ravinder, and Thomas Blom Hansen. 2015. “Aesthetics of Arrival: Spectacle, Capital, Novelty in Post-reform India.” Identities [Yverdon] 23(3): 265–275. https://doi.org/10.1080/1070289X.2015.1034135

Madhukumar, Suwarna, D. Sudeepa, and Vaishali Gaikwad. 2012. “Awareness and Perception Regarding Health Insurance in Bangalore Rural Population.” International Journal of Medicine and Public Health 22(2): 18–22. https://doi.org/10.4103/2230-8598.108390

Marx, Gary T. 2015. “Technology and Social Control.” In International Encyclopedia of the Social & Behavioral Sciences, 2nd ed., vol. 24, 117–124.

Nandi, Arindam, E. Phoebe Holtzman, Anup Malani, and Ramanan Laxminarayan. 2015. “The Need for Better Evidence to Evaluate the Health & Economic Benefits of India's Rashtriya Swasthya Bima Yojana.” Indian Journal of Medical Research 142(4): 383–390. https://doi.org/10.4103/0971-5916.169194

Narasimhan, H., V. Boddu, P.V. Singh, A. Katyal, S. Bergkvist, and M. Rao. 2014. “The Best Laid Plans: Access to the Rajiv Aarogyasri Community Health Insurance Scheme of Andhra Pradesh.” Health, Culture and Society [Pittsburgh, PA] 6(1): 85–97. https://doi.org/10.5195/HCS.2014.163

Organization for Economic Collaboration and Development. 2015. Health at a Glance: OECD Indicators. Paris: OECD Publishing

Palacios, R. 2010. “A New Approach to Providing Health Insurance to the Poor in India: The Early Experience of Rashtriya Swasthya Bima Yojna.” RSBY Working Paper 1. http://www.rsby.gov.in/documents.aspx?ID=14.

Peters, David H., Abdo S. Yazbeck, Rashmi R. Sharma, G.N.V. Ramana, Lant H. Pritchett, and Adam Wagstaff. 2002. Better Health Systems for India's Poor. Washington, DC: World Bank. https://doi.org/10.1596/0-8213-5029-3

Philip, Kavita. 2016. “Telling Histories of the Future: The Imaginaries of Indian Technoscience.” Identities [Yverdon] 23(3): 276–293. https://doi.org/10.1080/1070289X.2015.1034129

Rajasekhar, D., Erlend Berg, Maitreesh Ghatak, R. Manjula, and Sanchari Roy. 2011. “Implementing Health Insurance for the Poor: The Rollout of RSBY in Karnataka.” Research Paper, Suntory Centre, Suntory and Toyota International Centres for Economics and Related Disciplines, London School of Economics and Political Science. sticerd.lse.ac.uk/dps/eopp/eopp25.pdf

Rao, Ursula. 2013. “Biometric Marginality.” Economic and Political Weekly 4813: 71–77

Rao, M. Govinda, and Mita Choudhury. 2012. “Health Care Financing Reforms in India.” Working Paper 2012–100, National Institute of Public Finance and Policy. http://www.nipfp.org.in/media/medialibrary/2013/04/wp_2012_100.pdf.

Reshmi, B., N. Sreekumaran Nair, K. M. Sabu, and B. Unnikrishnan. 2007. “Awareness of Health Insurance in a South Indian Population – A Community-based Study.” Health and Population: Perspectives and Issues 30 (3):177–188. doi: 10.4103/0970-0218.69288

Roy, S. 2016. “Angry Citizens: Civic Anger and the Politics of Curative Democracy in India.” Identities [Yverdon] 23(3): 362–377. https://doi.org/10.1080/1070289X.2015.1034131

Sengoopta, Chandak. 2004. Imprint of the Raj: How Fingerprinting Was Born in Colonial India. London: Pan Books

Shahrawat, Renu, and Krishna D. Rao. 2011. “Insured Yet Vulnerable: Out-of-Pocket Payments and India's Poor.” Health Policy and Planning 27(3): 213–221. https://doi.org/10.1093/heapol/czr029

Sharma, Aradhana, and Akhil Gupta. 2006. “Introduction: Rethinking Theories of the State in an Age of Globalization.” In The Anthropology of the State: A Reader, ed. Aradhana Sharma and Akhil Gupta, 1–42. Oxford: Blackwell. https://doi.org/10.1385/CBB:44:01

Srivastava, Sanjay. 2012. “Duplicity, Intimacy, Community: An Ethnography of ID cards, Permits and Other Fake Documents in Delhi.” Thesis Eleven 1131: 78–93. https://doi.org/10.1177/0725513612456686

Sun, Changqing. 2011. “An Analysis of RSBY Enrolment Patterns: Preliminary Evidence and Lessons from the Early Experience.” In India's Health Insurance Scheme for the Poor: Evidence from the Early Experience of the Rashtriya Swasthya Bima Yojana, ed. Robert Palacios, Jishnu Das, and Changqing Sun. New Delhi: Centre for Policy Research

Swarup, Anil. 2013a. “Interview with Anil Swarup on India's RSBY scheme.” YouTube video, 3:04, posted by Social Protection Floor in Asia, 18 March 2014. https://www.youtube.com/watch?v=KY1k5d6FG2o&t=9s

Swarup, A. 2013b. “Smart card system of India's RSBY scheme.” YouTube video, 6:42, posted by Social Protection Floor in Asia, 18 March 2014. https://www.youtube.com/watch?v=fm5FmLLKwQo

Weber, Max. 1978. Economy and Society: An Outline of Interpretive Sociology. Berkeley: University of California Press

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How to Cite

Ecks, S. (2018). “When the Government Changes, the Card Will Also Change”: Questioning Identity in Biometric Smartcards for National Health Insurance (RSBY) in India. Anthropologica, 60(1), 190–200. https://doi.org/10.3138/anth.60.1.t18

Issue

Section

Thematic Section: Document/ation: Power, Interests, Accountabilities