EDITORIAL: Novel scheme

Implementation of the health insurance scheme will not be easy. It will not be sufficient to cover the health related problems of a family

The health insurance policy scheme for all citizens is something new for Nepal. Nepal should learn from many other countries where such a policy has already been implemented, thereby, benefiting many. A family of five is required to pay a premium of Rs. 2,500 which would cover medical services worth Rs. 50,000. An increase in this amount is being mooted, according to an official concerned. In a country where the majority of people are impoverished the health insurance policy would make medical services available to more people who would otherwise find it difficult to afford the expensive medical treatment being meted out at present. To this effect, the Legislature-Parliament had endorsed the eagerly awaited Health Insurance Bill on October 10. It is anticipated that within a month the regulations formed after much brainstorming would be forwarded to the Cabinet for approval through the Ministry of Health.

If the Bill has it way it would provide insurance coverage for all citizens for treatment of ailments like immunization, family planning safe motherhood, out-patient care, in-patient care, surgery, emergency care, curative services, rehabilitation, ambulance and other such services. The Bill would make the federal, provincial and local governments liable to bear the insurance premium for the poor and those marginalized. Civil servants, their families and those migrating would have to enroll in the health scheme. Also those employed in the organized sector would also have to do so in the health insurance policy system. So far, the government has been implementing the scheme as a pilot project in nine districts across the country. It had started as the pilot project in 2016. The government has now selected 14 more districts to put the policy into effect. The Social Health Security Development Committee has added the districts such as Bajhang, Bajura, Humla, Mugu, Dolpa, Kalikot, Rukum, Arghakhanchi, Ramechhap, Siraha, Khotang and Bhojpur to the health insurance policy programme. The policy would be implemented in 38 districts chosen within the current fiscal year.

As of now, 233,000 families in the country have enrolled in the health insurance policy which is very encouraging. It shows that people are being aware about the advantages of signing up for the health insurance policy.  That the government is planning to include all the 77 districts in the programme within the next two years should be taken positively.  Furthermore, when the Bill comes into effect it would be providing relief to many. Let all the citizens of the country have access to all medical services that they need. However, the coverage amount is meager compared to the cost of treatment of various ailments of a serious nature exceeding Rs. 50,000. This matter should also be taken into consideration and the concerned should make arrangements for them so that they too are provided the required health services. In certain cases, the costs for treatment should be waived as is sometimes being done now mostly in government hospitals. The implementation of the health insurance programme will not be easy. Moreover, it could be not be sufficient to cover the health related problems of a family. We should now work out how the patients would avail of the health service once they are insured.

Sick industries

The previous government had envisaged reviving the sick or defunct state-owned industries when the country was facing a border blockade. But the policy of reviving the defunct state-owned industries has received a backburner with the change of guard in the government. The Ministry of Industries, the line ministry, had taken various policy measures to bring the sick industries back to life by injecting financial supports from the state.

Under the policy, Nepal Drug Limited is the only state-owned industry that has been revived with state funding. It has been able to produce life saving drugs to be distributed by the government to public free of charge. Birgunj Sugar Factory, Gorakhkali Rubber Industry, Nepal Orient Magnesite Company and Butwal Yarn and Spinning Mill were also on the cards for revival. But they could not be brought back to life due to low priority of the incumbent government. The closed factories which have their land, infrastructure and human resources could provide job opportunity to thousands of people, and they could also generate revenues to the government if they are run with a new management contract.