Zafar Mirza, former adviser to PM Pakistan, said in a recent newspaper article that from the perspective of universal health coverage, essential health services must cover the entire population, without discrimination, giving priority to the most vulnerable.
Mirza further said that in mixed health systems like ours (Pakistan), government spending on health is far less than the lowest international threshold. Consequently, around 60 per cent of healthcare spending constitutes out-of-pocket expenditure.
Social Health Insurance in Pakistan
Social health insurance in Pakistan started out by protecting the poor against out-of-pocket expenditures through a prepaid arrangement.
The province of KP made it universal and the federal government took affirmative action by making it available to the entire population of Tharparkar, Azad Kashmir and erstwhile Fata.
Until June 2021, around 18 million poor and non-poor families ie around 81m people (37pc) in Pakistan had been enrolled in the programme.
Families living below the poverty line are identified using the National Socio-Economic Registry of the Benazir Income Support Programme’s poverty database that is linked with Nadra.
The Sehat Sahulat Programme at present provides health insurance only to those who require hospital admission. The programme covers a broad range of treatment ranging from minor to major problems including cardiac surgeries, dialysis, cancers and hospital deliveries. The spectrum of services is very generous. In fact, excluding dentistry, cosmetic surgery, implants and organ transplantation (though this is covered in KP) almost every other treatment for which hospital admission is required is covered.
The Sehat Sahulat programme is a flagship project of the government of Pakistan. It is one of the highly effective programmes of social welfare that people of the country have ever seen. It helps to identify under-privileged citizens across the country and provide them access to their necessary medical health care.
The programme works in a swift and dignified manner without any financial obligations. The programme’s objective is to improve access of the poor population to good quality medical services, through a micro health insurance scheme.
The programme has been started with two treatment packages, Secondary care and priority treatment.
Secondary Treatment Package
In secondary care , the initial coverage Rs 60,000 / family / year with an additional coverage Rs. 60,000 per family has been launched.
The package covers in patient services (all medical and surgical procedures, emergency treatment requiring admission, maternity services (normal delivery and c – section), maternity consultancy / antenatal checkups (4 times before delivery and one follow up after delivery, maternal consultancy for family planning, immunization and nutrition,
fractures / injuries, post hospitalization, and transportation cost of pkr 1,000 (thrice per year) along with the provision of transport to tertiary care hospitals.
The Priority Treatment Package
The priority treatment initial covers the cost of Rs. 300,000 / family / year
With an additional coverage Rs. 300,000 / family in patient services (all medical and surgical procedures), such as heart diseases (angioplasty/bypass), diabetes mellitus completion, burns and rta (life, limb saving treatment, implants, prosthesis), end stage kidney diseases/ dialysis, chronic infections (hepatitis/hiv/rheumatology),
organ failure (liver, kidney, heart, lungs), cancer (chemo, radio, surgery), and neurosurgical procedure.
How to get your quami sehat card?
The procedure to get this card is pretty simple. Anyone who wants to get the eligibility for this card can sms his/her national identity card number to 8500 and check their eligibility in the program.