National Health Insurance programme being launched

ISLAMABAD: Government has decided to launch Prime Minister’s National Health Insurance Program for 66 selected districts of the country in phased manner with estimated cost of Rs45.078 billion in five years.
This program is proposed to be financed through current budget as it cannot become part of development program under Public Sector Development Program (PSDP).Official documents available with The News disclosed that 100 million populations in all the districts in the phased manner shall be covered by health insurance under this proposed scheme.
The cost of the project is estimated at Rs45.078 billion without any foreign exchange component (FEC) for period of five years in three phases where phase-1 shall cover 3.3 million families in 22 districts at national level followed by another 3.3 million in another 22 districts in phase-II followed by universal coverage in all districts of Pakistan of 100 million population in 22 million families.
The estimated premium of Rs2000 per family per annum is proposed for secondary care with addition of Rs500 per family per annum for priority treatment, Rs50,000 per family per annum on floating basis provided within provincial Annual Development Plans (ADPs) for provinces and federal PSDP for AJK, Fata and Gilgit-Baltistan and Islamabad Capital Territory (ICT) Rs250,000 per family per annum on floating basis is proposed under PSDP for federal hospitalisation against identified treatment protocol.
The targeting beneficiaries’ households shall be conducted using BISP and Nadra database. The secondary care includes daycare & maternity services. The priority treatment list for inclusion consist of cardio regular disease, diabetes, burns, road traffic accidents, renal disease & dialysis, TB, hepatitis, treatment of HIV chronic liver disease, chemotherapy, radiotherapy & surgical oncology.
No exclusion for secondary hospitalisation coverage except criminals, self inflicted injuries, attempted suicides, nervous disorders, infertility, injuries resulting out of war, riots, invasion , HIV/AIDS, etc.
The yearly payment of premium in bloc manner is proposed dependant on successfully enrolment of beneficiary population by the insurance company.The federal Project Management Unit (PMU) under DG (project) in BPS-20 is proposed for management of the program at federal level, provincial PMU at provinces with regional PMUs under Director (BPS-19) for implementation.
The list of secondary care provider shall be developed by provinces and tertiary care provider by National Steering Committee for both public and private healthcare provider hospitals registered with Health Regulatory Authority.
During the last Central Development Working Party (CDWP) meeting under chairmanship of Federal Minister for Planning Ehsan Iqbal had deferred this project because certain policy issues were raised during the meeting.
According to technical appraisal done by the Planning Commission, stating that the PC-I is stated as an outcome of the initiative approved by PM with bloc allocation of Rs1 billion in the current budget. The Departmental Development Working Party (DDWP), Provincial Development Working Party (PDWP), Central Development Working Party (CDWP) and ECNEC approve projects funded under PSDP or provincial ADPs funded under PSDP or provincial ADPs. The approval of projects proposed to be funded under current (regular) expenditure needs policy consideration.
It was also raised that in pursuance to the 18th constitutional amendment, health service delivery has been devolved to the provinces. The PC-I under review depicts ministry of national health services regulation and coordination as the sponsoring and executing agency for the initiative which appears to be against the spirit of devolution.