PESHAWAR: The State Life Insurance Corporation (SLIC) has agreed to continue Sehat Card Plus (SCP) programme after assurance by the caretaker government to pay running cost of the free treatment scheme on monthly basis.

SLIC, which implements SCP, has outstanding amount of Rs17 billion against the government to pay to hospitals for free treatment of people under the scheme. The firm has stopped the programme for non-payment of dues to public sector medical teaching institutions (MTIs) and district headquarters hospitals.

In a meeting, held here with caretaker chief minister in the chair the other day, the insurer has agreed to continue the scheme if government starts paying it running cost of the programme on monthly basis.

The government, which is already facing financial crisis, has agreed to pay Rs3 billion to the insurance firm early next week so that the cashless healthcare programme is restarted in the empanelled hospitals including medical teaching institutions.

Firm agrees to continue Sehat Card Plus programme

Dr Mohammad Riaz Tanoli, the head of SCP, told Dawn that the government had already taken measures to bring down per month expenditures of the programme from present Rs3 billion to less than Rs1.8 billion for running the scheme on durable basis.

“We have already implemented the cabinet’s decision under which seven diseases including caesarean delivery, tonsillectomy, cholecystectomy, appendectomy, cataract, angiography and septoplasty and submucosal resection (SMR) are now being conducted only in government hospitals under the scheme,” he said.

Since October 1, these treatments have been restricted to public sector hospitals. It will cut down the monthly spending of the programme by Rs1 billion. “As per government’s directives, we are also in process to cut down the number of private empanelled hospitals for the programme. By next week, about 60 private hospitals would lose empanelment due to the implementation of new selection criteria,” said Dr Riaz.

So far, 192 hospitals -- 129 private and 63 public -- are admitting patients on SCP. Additionally, the programme is now offering total free services to only 65 per cent population of the province and the remaining 35 per cent people are required to undergo treatment on the basis of co-payment. It means that they will have to bear part of the cost of their treatment, they avail on SCP.

Dr Riaz said that those measures would make the programme more transparent and sustainable because most of the 35 per cent people already got private services despite their eligibility under SCP.

“Under the SCP’s criteria, people avail health services in general wards while the people falling in co-payment category spend from pocket on their treatment in private rooms and in hospitals of their choice. SCP offers services only in empanelled hospitals,” he said.

Dr Riaz said that such steps would bring down the cost of the programme to Rs18 billion per year from Rs38 billion.

Sources in SLIC told Dawn that MTIs stopped providing free treatment to people because the firm couldn’t pay them their dues. “As government releases the stuck-up amount, we will pay the hospitals,” they added.

They said that government hospitals, including MTIs, also faced problems as their budget was not released regularly by finance department. The income generated by government hospitals was their main sources from which they ran their routine services and paid salaries to their employees, they added.

They said that private hospitals continued providing services to patients on SCP and would get their unpaid amount soon.

Officials in health department said that they wanted to encourage public sector hospitals to receive more patients and earn more income through SCP. In future, more public hospitals would be empanelled instead of private hospitals, they said.

Under the new mechanism, public sector hospitals will earn more from the cashless treatment scheme and would not face financial crisis as they are facing now where most of the 10 MTIs are unable to pay salaries to their employees.

Published in Dawn, October 15th, 2023