Punjab govt tweaks Sehat Card policy, cuts affluent class
LAHORE: The caretaker Punjab government has approved certain key interventions in the Sehat Sahulat Programme (SSP), making them operational with effect from July 1 across the province.
Under the notable amendments, the government has excluded the affluent class from the ‘universal health insurance programme’, restricting it to the deserving, eligible and under-privileged class of the people earning up to Rs65,000 per month.
Earlier, even the most effluent/privileged and rich class of the society was also enjoying the fruits of this health scheme, despite the fact that they could easily afford all kinds of expensive treatment facilities from the leading private sector hospitals of Punjab.
The National Socio Economic Survey (NSES) data retrieved from the Benazir Income Support Programme and Muft Ata Scheme 2023 would be used to identify the eligible population.
Efforts to prevent programme misuse, focus on underprivileged patients
The caretaker government has also made separate hefty allocations of ‘reserve funds’ of Rs1.5 billion to extend free healthcare services to those eligible people who would not fall in the above-mentioned two schemes.
Punjab Caretaker Health Minister Prof Javed Akram confirmed to Dawn that the new interventions have been approved by the government.
He said that the government took this step following blatant misuse of the SSP by non-qualified junior doctors at the both public and private hospitals across the province.
Referring a shocking incident/case in this regard, he said, a non-eligible doctor (medical officer) performed cardiac surgery of a SSP-registered cardiac patient at a private hospital. The doctor implanted three stents, whereas the patient had required only one stent.
Similarly, a private hospital performed 48 surgeries of patients under the SSP in a single day, putting the lives of many at risk. He declared that it was humanly impossible to conduct such a large number of operations within this timeframe.
Additionally, he said that this was a serious violation of the internationally defined healthcare standards.
Another private hospital generated a bill of Rs900 million for the treatment provided to the SSP-eligible patients for few specific diseases, which also shocked the regulators, the health minister said.
He said that the Punjab cabinet approved the interventions in its meeting held on June 21.
Meanwhile, talking to media caretaker Information Minister Amir Mir rejected some reports that the government has stopped treatment to the cardiac patients, declaring it a propaganda campaign.
He said the SSP was originally brought by PML-N in 2015 for poor and deserving patients only.
However, a mafia became billionaires during the PTI tenure when a majority of the patients enrolled under the SSP went to the private hospitals.
Prof Akram said that the private hospitals earned billions of rupees by misusing the health insurance scheme.
“Now after amendments, those who were getting electricity bill of Rs8,000 or above would not be eligible to get healthcare facility under the SSP,” he said.
Similarly, he indicated that those people who were conducting foreign tours (affording class) would also not be the part of the health insurance scheme.
Prof Akram made another stunning revelation of a medical crime at a private hospital to generate maximum profit under the SSP, saying conversion rate of normal delivery cases into C-Section at the hospital in question was reported to be over 50 per cent.
He said the programme was misused at such a large scale in the cardiac surgeries that the mafias implanted unnecessary stents on the patients.
On the other hand, the sources said that the government took initiative in the light of the recommendations of some senior doctors when they complained that the programme was being misused by some mafias in the hospitals.
They also expressed serious apprehensions that the health minister of the previous regime (PTI/PML-Q) had blatantly ignored their proposals, probably to please the private hospitals.
A source said that many changes were introduced with a prime objective of diverting the major chunk of revenue from private to the public sector hospitals by discouraging the malpractice and corruption.
Notable complaints were raised regarding doctors trapping and shifting the SSP-registered patients from government hospitals to the private healthcare facilities, under the ‘so-called’ supervision of the senior doctors, solely for financial gains.
The Punjab Health Initiative Management Company (PHIMC) has intimated to the divisional head of the State Life Insurance Corporation of Pakistan to follow/observe strictly the new interventions as approved by the provincial cabinet.
A copy of the official directive issued by the PHIMC in this regard was also available with Dawn.
The PHIMC was overlooking the implementation of SSP services in collaboration with State Life Insurance Corporation.
Published in Dawn, July 3rd, 2023