The Khyber Pakhtunkhwa government restored Sehat Card Plus KP Services from the 1st of Ramadan. Following directives from newly elected Chief Minister Ali Amin Gandapur, the provincial health department has diligently finalized arrangements for the revamped Sehat Card Plus Programme.
It is reported that the K-P government in debt of around Rs 17 billion of SCP services owned to the state life insurance corporation. Khyber Pakhtunkhwa government is poised to settle outstanding dues owed to the state life insurance corporation in phases.
Initially the Khyber Pakhtunkhwa government has agreed to pay 5 billion rupees to state life insurance corporation which will kickstart the process of reinstating free treatment services across all hospitals on sehat card.
A structured plan also includes monthly disbursements of 3 billion rupees to the state life insurance corporation for the remaining arrears until all the outstanding debt is settled.
What are the benefits of the sehat card plus programme
Sehat Card is hope for millions of people across Khyber Pakhtunkhwa who Cannot afford expensive treatments because health programs encompass a wide range of medical services, including cancer treatments, dialysis, and various surgeries, accessible in 114 hospitals within the province. As per report, the coverage extends to 58 private and additional government hospitals. Since the launch of the Health Card project, approximately 30 lakh patients have benefited from free treatments, at a cost of 70 billion rupees borne by the government.
The Sehat Card program aims to provide universal health coverage to residents of the province, offering a wide range of secondary and tertiary care services. Initial coverage for secondary care (Basic Treatment) 200,000 PKR per family per year. Additional coverage for secondary care (Basic Treatment) 60,000 PKR per family per year. Coverage for tertiary care (Advanced Treatment) 400,000 PKR per family per year. Additional coverage for tertiary care (Advanced Treatment) 300,000 PKR per family per year. The total coverage for treatment Health expenditure is up to 1,000,000 PKR per family per year.
Loopholes of the populist health care insurance programme
While the health cards program improved access to healthcare, reduced financial burdens on lower-income segments of society, and expanded coverage to millions of families across province those in need but ground realities reveal some major’s flaws and corruption of various kinds health cards program.
Inadequate Monitoring
The major issues reported in sehat card program was the program’s monitoring and oversight mechanisms which not robust enough to detect and prevent double billing issues, making it easier for fraudulent claims to go unnoticed.
An example of inadequate monitoring in the Sehat Card program can be seen in the case of hospitals using substandard products like sutures, medicines, and test kits, for increasing their bills, like a news reported that there are doctors implanting up to three stents in cardiac patients where only one was required, two extra stents were inserted just to increase medical bill. There is also a case reported indicating serious violation of internationally defined healthcare standards, a private hospital carries out 48 surgeries of patients under the SSP in a single day, put the lives of many at risk.
Such case where patient safety and care quality were put at risk rise question on the monitoring and oversight mechanisms of the billion rupees health initiative program’s.
Double Billing
The Inadequate Monitoring system of Sehat card program led to double billing issue reported widely in the Sehat card program, where patients or hospitals claimed reimbursement for the same treatment or service multiple times which lead to financial losses for the program. There have been instances where hospitals or healthcare providers have submitted fraudulent claims for the treatment or service more than actual price, not just lead to financial losses for the program but for the patients also. Like, shocking news reported that a private hospital generated a Rs 900 million bill for treatment provided to the SSP-eligible patients for few specific diseases.
Privatization
The program has seen a significant number of people availing free treatment services from private hospitals, leading to a diversion of funds towards private healthcare providers rather than government hospitals which is hang in poor state. Moreover, there are also concerns that treatment through Sehat Cards may lead to the privatization of public sector hospitals, potentially will not create a parallel healthcare system detrimental to public hospitals but also question mark the accessibility, affordability, and equity in healthcare services in the long run.