A dream of quality healthcare

The Sehat Sahulat Card is to free a patient from financial worry

We, in the Punjab, are poised to make the dream of universal healthcare a reality. We are entering an era where no one will be denied treatment for lack of money. The state is finally going to be the proverbial caring mother that looks after all of its children. The entire population of the Punjab is going to be provided health insurance by the end of the year. Free healthcare for all shall no longer be a mere slogan, it is about to become a comforting reality.

In the first phase, we covered our marginalised population, those below the poverty line in the year 2020. Till date, more than 5.3 million families have received their health cards. There have been 330,000 hospital admissions. We have now started extending health insurance to permanent residents of Sahiwal and Dera Ghazi Khan divisions. The number of families covered is expected to reach 8.5 million in June. By December, we plan on covering all 29.3 million families – 100 percent of Punjab’s population.

Illness brings pain, misery and fear; more sometimes on account of financial difficulty than the disease itself. During my career as a doctor, I came across hundreds of cases where unexpected illness deprived people of a lifetime of savings and left them indebted. On hundreds of occasions, I resolved and promised myself I would work towards ending this one day. Finally, the hour to put an end to it has arrived.

Universal healthcare is a fundamental concept in public health. It implies providing healthcare to all with three core objectives: first, equity in access, everyone who needs health services should get them irrespective of their financial status; second, quality; and third, protection against financial risk.

The Sehat Sahulat Card is to free a patient from financial worry. The holder of the card can avail free-of-cost hospitalization including emergency services, in-patient services, treatment for fractures/injuries, referral transportation, maternity services and follow ups. In addition to secondary care, major diseases are covered under priority cover package including cardiovascular diseases, diabetes mellitus (complications necessitating hospitalisation), burns and road traffic accidents necessitating hospitalisation, end stage renal disease and renal dialysis, chronic diseases necessitating hospitalisation, organ failure, oncology (chemotherapy, radiotherapy, surgical treatment) and neurosurgery.

Overall, a card holder will be eligible to treatment costing up to Rs 720,000 a year. Where needed, the limit can be relaxed. In such cases, the government can provide relief through a further Rs 360,000 grant per family per year to complete the treatment. The basic benefit package is Rs 60,000 for secondary care treatment and Rs 300,000 for priority care treatment per family in a year. This can go up to Rs 180,000 for secondary care and Rs 900,000 for priority care per family a year, respectively, through the built-in excess-of-loss mechanism. Overall, the card holder will be able to get treatment costing up to Rs 360,000 annually.

Apart from the medical facilities, Sehat Sahulat Card provides support in transportation. The transportation cost paid per family per visit is Rs 1,000. Another feature of Sehat Sahulat Card is the provision for burial support. If a patient dies while admitted to the hospital, Rs 10,000 will be paid to the bereaved family in burial support.

The government has empanelled 247 hospitals, most of those in private sector. To ensure quality treatment, all hospitals with adequate medical facilities have been taken on the panel. As treatment at government hospitals has been either free or subsidised, the patient load is immense. With a lot of patients getting treatment from public sector hospitals, these hospitals sometimes fail to provide adequate health services. This results in referrals and complaints. The Sehat Sahulat Card has opened choices for the patients; they can opt for any empanelled hospital. This is also expected to reduce the burden on public sector hospitals and result in improved services.

In most developing countries, the funds allocated for the health sector are considered an investment rather than an expenditure. Most developed countries have ensured provision of healthcare services to all under blanket health insurance systems. The expenses of health insurance are borne either by the government or social security institutions. The services covered under Sehat Card are by no means less than those provided in countries like the US and the UK. Like these developed countries, no patients will now be denied treatment in Pakistan. The government will provide for this. Everyone must have access to quality healthcare. Healthy people make a healthy nation. Good health allows children to learn and adults to earn, it helps people play their roles in the social and economic development of a country.

The most satisfying moment of my life will be the day when no one in the country will have to beg for treatment, compromise their self-esteem or sell family assets for the treatment of an ailing child. The day is not far when everyone will have equal access to quality health services.

The writer is the health minister of the Punjab. She retired as a professor of obstetrics and gynecology at King Edward Medical University. For queries and feedback: Manager Minister’s Delivery Unit [email protected]

A dream of quality healthcare