It is, indeed, heartening to learn from news reports that the Asian Development Bank financed an initial feasibility study on social health insurance, and it was completed last year. As a sequel to this, the ADB will provide Technical Assistance to Punjab in developing a pilot health insurance scheme, covering civil servants as well as the poor and the informal sector.
This was revealed by Axel Weber from ADB, in his presentation on "social health insurance for Pakistan: opportunities & limitations", saying that this programme was the need of the hour, as it would provide some relief to the poverty-stricken people of Pakistan.
The occasion was a workshop in Islamabad, on "Developing a Social Protection Strategy for Pakistan," held under the auspices of the Planning Commission, in collaboration with the ADB, World Bank, and Department for International Development (DFID). Axel is reported to have lamented that the people in this country are under immense pressure, especially from the increasing burden of health care costs. He said 80 percent of small landowners had to lose their property due to serious health problems, as high health care costs have plunged many people into poverty.
Referring to the advantages of health insurance, Axel pointed out that it helps finance a network of efficient health care institutions and provides the most appropriate social protection instrument, to start with. Introduction of health insurance programme would also help maintain quality and prices of medicines in Pakistan.
For, as he explained, patients have to pay heavily not only for drugs, but also for examinations and for services in public health facilities. As for the plight of the poor, he pointed out that they can apply for Zakat fund, or approach Baitul Mal for subsidy, for which only a few are eligible. Summing up the overall conditions, he pointed out that most people, including public servants, have to pay for health care.
While the situation elsewhere in South Asia is about the same, Korea is an exception where extended insurance scheme covers almost the entire population. Viewing the scene in that developing country, it should make one conclude that given the will, everything is possible.
This is not to say that no medical relief is available for the poor and destitute in Pakistan. For, many Pakistanis have been benefiting from a number of charitable trusts, some of them catering for them in real big way. Economic experts, speaking at the workshop urged the government to introduce social health insurance programme to provide the poor with a cushion to bear the impact of health-related problems. Reference, in this regard, was made to the plight of many who had to carry for years the excruciating burden of high interest loans from moneylenders to cover costs of health care.
It will also be noted that of late the free treatment facilities available at government hospitals are being slashed, thereby pushing more and more down the poverty line. This happening in the midst of an ambitious poverty-reduction schemes would make the Punjab initiative worth emulation by the other provinces too. As for other efforts in this direction, some consolation may be had from the hint of a plan being made by the State Life Insurance Corporation for accident insurance cover for every Pakistani citizen, in order to create a sense of security among poor people.
This was revealed by the Corporation Chairman, Kamal Afsar, while briefing newsmen after its Convention 2005 at Bhurban. He also pointed out that Slic was in touch with the provincial governments and philanthropists, asking them to pay the premium for this scheme. But, he said, the Punjab government alone had given a positive response, while other governments were still looking into the matter.
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