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Thursday, December 31, 2015

WSJ report on How Pakistan’s National Health Insurance Program Will Work ?

How Pakistan’s National Health Insurance Program Will Work

Pakistan’s government launched a national health insurance program for its poorest households Thursday, marking the start of the most-ambitious public health project in the country’s history.
The Prime Minister’s National Health Program will from Thursday cover families that make less than $2 a day through a gradual rollout. In the first phase, over 3 million families will get health insurance in 23 districts, with the ultimate aim to cover 22 million households across the country, officials said.
“This is another step towards the welfare state that we promised to create when we came into power,”said Pakistani Prime Minister Nawaz Sharif.
The Pakistani government already subsidizes health care to varying degrees in public hospitals, but officials acknowledge these facilities are unable to handle the patient load or achieve public health targets.
The government said earlier this year that it wouldn’t be able to meet the United Nation’s targets for child and maternal mortality rates that formed part of the Millennium Development Goals, which had a deadline of 2015. Critics have blamed Pakistan’s low health spending and inadequate management as key factors in the poor health provision. Between July 2014 and March 2015, Pakistan spent just 0.42% of its GDP on health. The U.S. government spends about 8.3% of GDP on healthcare.

The new insurance program will cover treatment at both public and private hospitals. Private hospitals that sign up will then be offered loans on easy terms to upgrade their facilities, officials said, without providing further details about interest rates and conditions.
Saira Afzal Tarar, minister of state for health Services, regulations and coordination, said most Pakistanis pay out of pocket for treatment. “There is treatment at government-run hospitals, but there are long lines. Those who don’t have a recommendation have to wait months for treatment,” Ms. Tarar said at the launch ceremony in Islamabad. “With this [health insurance] card, you’ll be able to go to the hospitals where you weren’t allowed to even go to the front door. Now, you’ll be treated there with dignity and respect.” Ms. Tarar said.
The national health program, with an initial funding of 9 billion Pakistani rupees ($86 million) will pay for the treatment of the types of illnesses identified by the government as critical: heart disease, diabetes and related illnesses, cancer, kidney and liver diseases, complications from infections like HIV and Hepatitis, road accidents, and burn injuries. Officials said coverage can be extended to other conditions considered life-threatening.
The government said Thursday that the program will be run in partnership with provincial governments, which will share the financial burden. Beneficiaries will receive insurance cards, after selection from a database of low-income Pakistanis set up in 2008 for a separate cash support program.
The coverage includes 50,000 rupees for general treatment, and 300,000 rupees for serious illnesses. Mr. Sharif said on Thursday that the government is making arrangements for an emergency fund that would extend coverage to 600,000 rupees for cases that require longer treatment.
Officials on Thursday didn’t provide specific timelines for the rollout of the next phase, which is expected to cover another 3.3 million households. The finance ministry said earlier this year that the program aims to cover 22 million families.
The finance ministry, quoting World Bank data and 2008 population estimates, said last year that if living on $2 a day is taken as the poverty line, over 60% of the population would fall in that category.