EDITORIAL: Ad hoc decision

The best way of taking care of the problem of footing the high medical bills would be to bring a universal medical insurance policy

With the new government taking over, the impression conveyed to the public by the new Health Minister, Gagan Thapa, was that some clear criteria would be made for providing medical assistance, including for those in power.

Ad hoc ways of squandering the public money in the name of medical assistance had come under fire from many, including the health minister himself, and a new policy on the medical assistance is reported to have been drafted, including the assistance ceilings of fifteen lakh rupees, but the Cabinet is reported to be sitting on it.

In the meantime, however, a medical assistance of fifty lakh rupees has been approved by the Cabinet towards meeting the medical treatment costs of Nepali Congress leader Sujata Koirala.

The Cabinet decided even without the recommendation of the Medical Board, a requirement even under the existing rules. The health minister was out of Kathmandu at the time the Cabinet made the decision.

The parliamentary Finance Committee had also directed the government to provide medical assistance to anybody only under certain clear criteria, not on an ad hoc basis as has been practiced for years.

It is not a question of Sujata Koirala as a person. We sympathise with her on her disease and wish her early recovery.

But the concern is over the lack of systemic intervention on the issue of whether medical assistance should be provided to anybody including those in positions of power, and if yes, how much and how many times, and under what criteria.

The Cabinet has become very liberal in giving away large sums of the taxpayers’ money to people in power or with access to power in the name of medical assistance, often much in excess of what their treatment of medical problems would involve.

This has led VIPs to seek medical assistance abroad rather than at home even for diseases which could be well treated at home. If there is someone else to foot your bills, you would be highly likely to seek the comfort of foreign hospitals, even for an ordinary medical checkup.

This ad hoc way of giving away the public money means that some selected people will get government assistance without limits, and others without access to power will have to fend for themselves.

This is gross injustice at the hands of the State.

The public hopes generated by the health minister’s recent enthusiasm about making a policy on the matter seem to have come down. He cannot therefore escape unhurt morally by just passing the blame on to the Prime Minister or anybody else.

The State should limit its medical liability to any V/VIP in the first place. It cannot go on spending any amount of money on their health checkup or treatment abroad.

The best way of taking care of the problem of footing the high medical bills would be to bring a universal medical insurance policy under which all people, including those in power, should contribute by way of a premium.

This kind of scheme would save a lot of public money. But the political class and bureaucrats have been the main stumbling blocks to stopping the government treasury from being squandered to foot the medical expenses of politicians and high-ranking bureaucrats.

It is a great problem how they can be made to make a decision to cut their own benefits for the sake of justice and fair use of the public money.

Dearth of doctors

The government has set up many hospitals, primary health care centres and health posts in all districts to provide health care services to the public.

The government also provides some medicines free of charge. But the government has not been able to dispatch the required number of medical practitioners in all hospitals and health facilities despite its firm commitment.

It may be recalled that PM Pushpa Kamal Dahal in his first address to the parliament shortly after being sworn in had pledged that the government would send doctors in all districts and health centres. Sad to say, he failed to keep his promises.

The doctors who are dispatched to remote districts and health facilities hardly reach there, let alone provide health services to the people.

They either get their posting transferred in urban centres using political clout or quit the job. This is the major reason why people in remote areas are always deprived of even basic health care services.

In order to keep doctors in rural areas and remote districts for a certain period of time the government must offer them an automatic opportunity for higher level studies and also offer extra perks for staying in rural areas.