Healthcare Spending II – Blog Post #454 by Asrar Qureshi

Healthcare Spending II – Blog Post #454 by Asrar Qureshi

Dear Colleagues!  This is Pharma Veterans Blog Post #454. Pharma Veterans welcomes sharing of knowledge and wisdom by Veterans for the benefit of Community at large. Pharma Veterans Blog is published by Asrar Qureshi on WordPress, the top blog site. Please email to asrar@asrarqureshi.com for publishing your contributions here.

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The concept of buying health insurance privately is virtually non-existent in Pakistan. 

Our people are quite familiar with life insurance, and it has been around for ages, but very few people actually get insured. Medical facility is provided to employees of government and semi-government institutions by their parent institutions. The scope of coverage and benefits varies between departments and with the grade. Some corporations offer full medical coverage to entire family even after the person has retired. Others may be less generous and may cover immediate family only. 

Labor working in any industry is required to be registered with the Social Security Institution established by the first PPP government led by Z A Bhutto. It is a province level institution which provides medical facility to labor and supervisors (not officers) through its own dispensaries and hospitals and by referring to tertiary care hospitals, if needed. The employer is required to pay a certain amount for each labor head count registered. The SSI facilities have improved much with time, but the system has not. With the ‘help’ of SSI staff, almost all industries register a small portion of the actual number with SSI to save on payment. The records are falsified, and the entire process is hoodwinked by both parties. Result is that the intended benefit does not reach the intended recipients.

Health insurance is offered by three major insurance providers: Jubilee, EFU Allianz and IGI. The plans are available for individuals, families and corporates. Most of the corporates are offering health insurance to their employees through one of these insurance providers. The scope of benefits is directly related to the grade/cadre. It is still a great facility for employees in a time of need. The insurance companies are also in profit as most employees are young and do not need medical care even once in a year. The most used facility is probably related to childbirth. This system is by and large working well with few discrepancies here and there. Having said that, even this facility is being offered by only a small percentage of corporates.

Pakistan Tehreek e Insaf introduced Insaf Health cards, first in KPK during their provincial government between 2013-2018. Since they came to power in the center, they have been trying to extend it to other provinces. The program is now called Sehat Sahulat Program; the details can be found at https://www.pmhealthprogram.gov.pk/ .

Sehat Sahulat Program is health insurance supported through State Life Insurance Corporation. Over seven million families are enrolled till now and more are in progress. 

The program offers free-of-cost indoor medical facilities to people below poverty line, persons with disabilities and transgender communities who are registered with NADRA and have specialized CNICs. 

Initial coverage is 60,000 per family per year with additional coverage of 60,000 for simple medical and surgical procedures, antenatal checkup, deliveries, injuries, fractures etc. For more serious and life-threatening conditions, initial coverage is 300,000 with additional coverage of 300,000. These include heart disease, end-stage kidney disease, burns, cancers etc. 

There is no doubt that it is a good initiative. There are bugs in the execution as seen in all government initiatives. An even greater concern is about its future. What will happen when the government will change?

Healthcare in Pakistan has its good things and bad things. Good things are that our doctors are capable, diagnostic facilities are updated, hospitals have latest equipment and nursing care has improved. One does not need to go abroad for most procedures, and the overall cost is a fraction of what it would cost outside Pakistan. Bad things are that medical business is mired with greed of the highest order. The doctors, labs and hospitals have joined hands together to fleece the patients to the last penny they may have. The public sector hospitals are overburdened, disorganized and mismanaged. Corruption in the society has ample reflection in the healthcare system. 

Healthcare is a basic necessity of people and integrated steps are needed so that this basic facility is extended to public at large.

Concluded.

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