Sehat Sahulat Programme: Insurance firm asked to revise surgical treatment rates
LAHORE: The Punjab Health Initiative Management Company (PHIMC) has recommended to the State Life Insurance to revise rates of the surgical treatment to ensure uninterrupted healthcare to the patients under Sehat Sahulat Programme.
The recommendations were sent to the company following the complaints of the public and private sector hospitals registered under the programme that the rates for the treatment of various diseases were not compatible with the expenses being incurred at the health facilities.
The hospitals have objection to the rates for C Section, cardiac and a few other surgical interventions/operations, demanding rationalisation to ensure uninterrupted treatment.
PHIMC Chief Executive Officer Ali Razzaq dispelled the impression that the healthcare services under the programme had been suspended or delayed. He told Dawn on Wednesday that the government had strictly directed to ensure treatment of the patients under the scheme and denied the reports that the programme was likely to be rolled back by the PML-N government.
“It is a game-changer mega scheme that is purely the initiative of the PML-N government which was launched for the first time in 2015,” Mr Ali said. He added that the then government had launched the programme in Faisalabad, Narowal and Rahim Yar Khan.
The programme was expanded by the PTI government from three to 13 districts when it came into power in 2018. The scheme was later implemented in all the 36 districts of the province in 2022 covering all the families, he said.
He said the programme was offering various kinds of healthcare services. Primarily, they include open heart surgeries, insertion of stents, management of cancer, neurosurgical procedures, burn management, accident management, dialysis, intensive care management, deliveries, C-section and other medical/surgical procedures up to the limit of Rs1 million per family per year.
The services were being provided absolutely free of cost at the registered hospitals of Punjab, he said.
“All the 778 registered public and private hospitals in Punjab have sent their claims to the State Life Insurance Corporation amounting to approximately Rs73 billion which have to be paid from the national exchequer,” the PHMIC CEO said.
Of them, nearly Rs35 billion expenses were claimed by the hospitals for providing treatment to the poor patients only as initially the programme was limited to these people only.
While the other amount was generated by the healthcare facilities when the scheme was expanded to provide treatment cover to all categories of patients, he said.
“Under the given scheme 77,000 beds have been allocated/reserved in the 778 registered hospitals for admission of the patients,” Mr Ali said. He said approximately 1.1 million patients had undergone treatment under Sehat Sahulat Programme in the registered hospitals of the province.
Since January this year, he said, these hospitals had made 400,000 admissions and on average these days the hospitals were attending/receiving 8,000 patients daily.
“Since the start of the health card in 2015, the State Life Insurance Corporation of Pakistan has been dealing with the scheme,” he said.
Mr Ali said the same company again won the contract in 2022 and would continue to provide services till 2025. Currently, he said, 100pc population of Islamabad, Punjab, Khyber Pakhtunkhwa, Azad Jammu and Kashmir and Gilgit-Baltistan had been entitled to get free treatment.
Published in Dawn, April 21st, 2022