PESHAWAR: The State Life Insurance Corporation on Saturday urged the provincial government to pay Rs6 billion for the continuation of the Sehat Card Plus health programme in the province.

In a letter, the insurer asked all hospitals empanelled for the programme to stop new patient admissions under the Sehat Card Plus until further directives.

It advised private hospitals to refer cases to government hospitals, which will also carry out lifesaving procedures in the absence of the programme.

However, the SLIC rescinded its decision to suspend services and announced it would continue operations after the government promised to pay Rs6 billion by next Friday, according to health officials.

Minister, CM aide to meet SLIC’s representatives on Tuesday

They told Dawn that the health insurance programme had been facing issues since the last caretakers stopped payments to the insurance firms citing financial crisis as the reason.

Officials said the programme had been restricted to three emergency diseases for several months, with the liabilities surging to Rs24 billion.

They said after the installation of the current PTI government in the province, the health programme resumed due to the release of funds in March this year.

Officials said since March 12, the government had paid Rs13 billion to the SLIC but the latter wanted payment of Rs6 billion to be able to keep the cashless healthcare programme afloat. They said currently, the liabilities totalled Rs18 billion.

Officials said that adviser to the chief minister on finance Muzzammil Aslam and health minister Qasim Ali Shah were scheduled to meet with the representatives of SLIC on Tuesday over the SCP’s affairs, with the sought-after amount expected to be released.

They said the insurer had been promised Rs3 billion per month at the time of SCP’s resumption in March.

Officials said of the monthly installment by the government, the insurer would incur Rs2.5 billion on current expenses, while the remaining Rs500 million would be paid to the hospitals as dues.

They said that the government should continue monthly payment to the SLIC as the programme expenses had gone up after its recent restoration.

Officials said the government had spent over Rs88 billion on the programme since 2020 with 3.5m patients undergoing treatment.

They said the government had also decided to limit seven procedures to public government hospitals only after reports that patients were unnecessarily admitted and operated upon by surgeons for getting more money.

“Now, procedures like caesarean delivery, tonsillectomy, cholecystectomy, appendectomy, cataract, angiography and septoplasty and submucosal resection are being carried out in government hospitals,” a health official told Dawn.

He said as the time passed, awareness of the SCP had increased and the people with Khyber Pakhtunkhwa’s national identity cards sought free treatment not only in local hospitals but in empanelled hospitals in other provinces as well causing the costs to rise.

The official said in the months of July and August this year, the government spent Rs4.7 billion on the services provided to 188,456 patients under the SCP.

Other officials said that the PTI government, which launched the programme, did not want to discontinue it and would provide the required amount to SLIC but that the issue of funding the insurer would continue to stay around.

They said that the caretakers had devised a formula to cut down the programme’s costs but it was rejected by the PTI after assuming power in the province.

The officials said under that proposed formula, the government was required to fully sponsor treatment of 33 per cent of the population and partially of the remaining.

They added that even today, around 10 per cent of the province’s residents didn’t avail themselves of the free healthcare under SCP as they wanted private rooms and executive services, which were not covered in the programme.

Published in Dawn, September 8th, 2024