PESHAWAR: State Insurance Corporation has stopped dialysis, provision of intensive care services and treatment of cancer on Sehat Card Plus (SCP) owing to non-availability of funds.

“Under the free health insurance initiative, treatment services are provided to those patients, who exhaust an approved package of Rs400,000,” officials in State Life Insurance Corporation (SLIC) told Dawn.

Meanwhile, the SCP has informed people that there is zero balance in “reserve fund” due to which those patients, who have already spent their limit of Rs400,000 during the current year, will not be entertained. As soon the reserve fund is restored their treatment would resume as usual. However, others services will stay afloat as usual.

The free treatment programme, started in 2016, has been facing financial issues since the installation of the caretaker government in the province. The State Life Insurance Corporation suspended the programme on April 19 owing to non-payment of its dues by the government but restored it the very next day after intervention by Prof Abid Jameel, the former health adviser to caretaker chief minister.

Officials say meeting being held today to discuss the issue

The treatment services were resumed when the government issued Rs2 billion on April 21 but a similar amount was yet to be paid to the firm, executing the programme.

The SLIC officials said that they had informed health department that as per agreement of SCP programme, the cost of treatments beyond the covered limit was financed from the account of reserve fund.

They said that each and every patient was entitled to avail secondary and tertiary care services worth Rs400,000 in normal circumstance but requiring more money from the SCP was approved by reserve fund committee.

The patients suffering from cancer or those undergoing dialysis or getting intensive care in ICU in addition to those undergoing kidney and liver transplants are also beneficiaries of the reserved fund because the services they need cost more than Rs400,000.

Officials said that SCP was informed that there was no money left in the reserve fund due to which the services could not be extended to patients anymore.

“Continuation of treatment under reserve fund could not be extended due to which we have requested to issue funds for resumption of the treatment of the patients, who have exhausted their approved under the agreement,” they said. They added that standard secondary and tertiary treatments under the programme would, however, remain continued.

Officials said that the government was required to pay the SLIC an amount of Rs6 billion for March and April so that the patients requiring more money for their treatment could be entertained. They added that the insurance company maintained reserve fund from the premium they received from the government.

In each instalment paid by the government, the SLIC deposits 1.5 per cent in the reserve fund, which is utilised for the treatment of those patients, who have already exhausted their approved amount under the package.

They said that stoppage of services from reserve fund would adversely affect the cancer, dialysis, accidents and ICU patients because they could not discontinue their treatment. They said that more than 500 patients were undergoing dialysis only the hospitals in Peshawar. There are other patients in Swat, Dera Ismail Khan, Abbottabad, who regularly receive free dialysis under SCP. They will be hit hard as they will have either to pay from their pocket or discontinue their treatment.

Similarly, cancer and ICU patients will be at the receiving end as they cannot stop their treatment. However, the patients waiting to undergo liver and kidney transplants can wait.

Senior officials at the secretariat said that a meeting would be held with caretaker chief minister today (Wednesday) to discuss the issue and help the patients through allocation of the desired funds to the insurance firm.

Published in Dawn, May 3rd, 2023