ISLAMABAD: The success of an ambitious Sehat Sahulat Programme of Pakistan Tehreek-e-Insaf (PTI) to provide health insurance to more than eight million families - 40 million individuals - remains uncertain as the fate of similar programmes launched by Pakistan People's Party and Pakistan Muslim League Nawaz - Waseela-e-Sehat Programme and Prime Minister National Health Programme - proved unsuccessful due to funding constraints.
In December 2019, the then Special Assistant to the Prime Minister on National Health Services Dr Zafar Mirza announced that the federal government would distribute 10 million Sehat Insaf Cards to 2 million families (on the basis of five per family) across the country this year (2020) under Sehat Sahulat Programme. For the provision of these 10 million cards, the federal government signed an agreement with State Life Insurance Corporation of Pakistan (SLICP) according to which the government would pay a premium of Rs 1,998 per family, reduced from Rs 2250 on the court order, for health insurance to two million families at a cost of which Rs 4 billion.
Sources said that 10 million people are being randomly identified from different parts of the country through NADRA's (National Database and Registration Authority) data analytics on the basis of their financial income, social status and related factors.
Citizens interested in obtaining Sehat Insaf Cards are required to first determine their eligibility status by sending a text message to a NADRA designated number. In case they are eligible, the candidates need to visit their respective Sehat Sahulat Centre set up in every district to obtain Sehat Insaf Cards after submission of necessary documents.
Apart from this programme, Khyber Pakhtunkhwa government launched Sehat Sahulat Programme last month for all residents of Khyber Pakhtunkhwa (those with Computerized National Identity Cards issued from Khyber Pakhtunkhwa and those domiciled in KP).
Under this initiative, KP aims to issue Sehat Insaf Cards to 6 million families comprising of 30 million individuals (family size five members per family). The KP government has signed an agreement with SLICP according to which the provincial government would provide Rs 2,849 per family for health insurance facility at a cost to its exchequer of Rs 17 billion.
In total, the federal and KP government would pay over Rs 21 billion to SLICP as annual premium for the provision of healthcare insurance to 8 million deserving families under Sehat Sahulat Programme.
An official of the insurance corporation told Business Recorder that agreements to this effect have been signed by both the governments (federal and KP) through competitive bidding under Public Procurement Regulatory Authority (PPRA) rules.
According to the agreement, the insurance company would bear the expenses for the treatment of the patients in case they exceed Rs 21 billion, an official said on condition of strict anonymity.
"Idealistically, Sehat Sahulat Programme is a dream come-true for many poor families but practically, I doubt it can be implemented on such a large scale. One must not forget the health conditions in our country. The number of people falling ill and catching serious ailments is increasing day by day. But people prefer to stay at home instead of visiting government hospitals due to their poor healthcare standards and private hospitals are simply unaffordable. In such a situation, more and more people would try to avail Sehat Insaf Cards which means the expenses may well exceed the amount allocated by the government and SLICP would have to bear the brunt. It is likely that this insurance company may join the list of all those government organizations that are regarded as loss-making entities," the source said.
Both PPP and PML-N governments had signed agreements with SLiCP for extending health insurance facilities to the public but their respective programmes had to be abandoned, sources told BR.
Waseela-e-Sehat programme was launched by the PPP government and Prime Minister National Health Programme was launched by PML-N government with a budget of Rs 25 billion but both programmes were abandoned in 2016 when Nawaz Sharif was Prime Minister due to economic constraints. The beneficiaries of both these programmes were also identified through NADRA's data analytics, but the verified number of the beneficiaries is not known due to unavailability of any consolidated data.
Government sources claim that no more than 10 per cent of the population in any province or countrywide needs to be hospitalized for medical treatment with only a handful of patients suffering from serious diseases. So, the expenses incurred on the treatment of patients would be quite manageable, they said.
The health coverage to deserving families is envisioned to be under two categories - major and secondary diseases. Major refers to serious illness with up-to Rs 600,000 limit such as cardiac, liver, kidney, hepatitis, and diabetes and secondary refers to relatively minor ailments with up to Rs 120,000 on hospitalization.
Sources also clarified that Sehat Sahulat Programme is being run completely under the administrative ambit of Ministry of National Health Services, Regulations and Coordination (NHSRC) and it is unrelated to Ehsaas Programme, Pakistan's largest social safety initiative, being run by Poverty Alleviation and Social Safety (PASS) Division.
In KP, the government has set an ambitious target of giving Sehat Insaf Cards to 6.05 million families and 30.5 million individuals in the next five months till January 2021. Official sources told Business Recorder that the distribution of Sehat Insaf Cards in Khyber Pakhtunkhwa has been categorized in six zones. In these zones, 6.05 million families comprising of 30.5 million individuals would be issued Sehat Insaf Cards in a phase-wise manner.
Copyright Business Recorder, 2020
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