Himalayan News Service
KATHMANDU: A steering committee, formed six months ago to conduct a study on social health insurance, has submitted its report to the Ministry of Health and Population (MoHP).
MoHP is introducing social health insurance for people on a national scale.
At present, the ministry is selecting health issues that could fall under the social health insurance scheme as the present constitution recognises every citizen’s right to health as a fundamental right. According to the interim constitution, every citizen shall have the right to basic health service free of cost from the state as provided by law.
Yogendra Gauchan, chief of finance and administration section at the ministry and member of the steering committee, said the report recommends strengthening existing facilities and mechanisms prior to introducing the new policy. He added that the committee has made suggestions for improving community health insurance by plugging the loopholes that have been observed in the six VDCs of six districts where the programme is being piloted.
“The committee has also suggested that the ministry include civil servants in the insurance scheme in the first phase,” said the chief adding that they are trying their best to start insurance for civil servants from this year. The committee has suggested a mixed model for insurance in the country.
The ministry said community health insurance started at Manlabare Primary Health Care Centre (PHCC) in Morang District focusing on high-cost and low-frequency illness (catastrophic spending), and at Dumkauli PHCC, Nawalparasi on low-cost, high-frequency illness in 2003/04 as pilot projects. The low-cost, high-frequency illness model was expanded to four more districts as pilot projects in 2006/07: Katari PHCC in Udayapur, Chandranigahapur PHCC in Rautahat, Lamahi PHCC in Dang, and Tikapur PHCC in Kailali, representing the five development regions for potential replication.
The premium per family ranged from Rs. 500 to 1,400 and benefit package ranged from Rs. 3,000 to 20,000 annually. The pilots target a population of 0.581 million, however, the coverage was limited to only 5.1 per cent in 2009. The share of the subsidy ranged from 46 per cent to 64 per cent in 2009.