EDITORIAL: Health insurance

Since there would be much benefit accruing from the draft Health Insurance Bill, all the stakeholders should see to it that it is implemented

The Ministry of Health (MoH) has come up with a novel plan to enable it to provide basic health care to all Nepali citizens. The government has endorsed a draft of a Health Insurance Act.

The Council of Ministers endorsed the bill on Tuesday, and this would be registered in the Parliament soon.

According to the bill the federal, provincial and local governments would foot the health insurance premium for the poor and marginalized.

It would also require rehabilitation shelters, orphanages, old-age homes and correction centres to enroll the disabled, orphans residing in them for health insurance.

The bill has not decided the amount to be covered by the insurance under the scheme for making the bill more flexible. This would permit the government to set a ceiling for treatment by enforcing some regulations.

As per the bill, patients can use the services of the big hospitals after being referred to by the health posts and primary health care centres if treatment is not possible there.

Those with the government health insurance policy would also be able to receive treatment from private hospitals which have signed a memorandum of understating with the MoH whose cost would be reimbursed by the government.

The MoH had launched a pilot project last year in Baglung, Ilam and Kailalit where health insurance programmes were introduced. The MoH had collected Rs. 2,500 as premium from a family with five members making it eligible for treatment equivalent to Rs. 50,000 in one year.

An extra Rs. 425 was taken as premium for additional family members. Treatment up to Rs. 50,000 would be provided under the insurance scheme. It has also made it mandatory for civil servants and migrant workers to insure themselves and their family.

Those working in the private sector are also required to enroll their families in this government scheme for benefits.

Among the benefits of the health insurance bill is that people would get free access to yoga, immunization, family planning, safe motherhood, out-patient care, in-patient care, surgery, medicines, emergency care, curative services and also for ambulance services.

However, the scheme does not envisage providing air ambulance services for free. The government also would be providing additional services should they be required according to its discretion.

The main objective of the health insurance bill is to see to it that no one is denied basic health services. At present, the bulk of the population are deprived of such services. Thus, this scheme would work to provide the necessary health services for all. Now it has to start enrolling the people in the insurance programme.

No doubt, this would be an uphill task but it has many benefits. Now that the bill has been endorsed the MoH should provide the health insurance programme.

Meanwhile, the amount of premium should be set too so that the average Nepali family can afford it.

Since there would be much benefit accruing from the draft Health Insurance Bill, all the stakeholders should see to it that it is passed and implemented.

The government’s health insurance programme is timely and the need of the hour as many Nepali citizens cannot afford treatment as a result of which they have been suffering.

Efforts should be made to involve all the private sector in this scheme too for the scheme to succeed.

Slum problem

With the rise of population slum settlements are mushrooming in the urban areas, particularly in the Kathmandu Valley, where informal dwellers have encroached upon public lands and river banks.

Urban slums are characterized by lack of access to improved drinking water, sanitation facilities, sufficient living space, poor structure and their durability and problem of land ownership.

Slum settlement is the major problem of most Asian cities where people keep coming for better jobs and manual work, not always found in rural areas round the year.

It is estimated that around 10 percent of the urban population lives in informal settlements or in slums.

Such people live in river banks causing much difficulty for municipalities to manage urban life and preserve the public spaces that can be used to maintain greenery.

As the new constitution has guaranteed the right to living, education and health care the government must come up with a plan so that the areas can be settled in collective and planned housing to maintain the beauty of municipalities.