PESHAWAR: The Khyber Pakhtunkhwa government has agreed to pay Rs5 billion to the State Life Insurance Corporation next week for the resumption of the health insurance programme Sehat Card Plus in the province from the first day of Ramazan.

“The government has agreed to pay Rs5 billion next week and Rs3 billion every month afterwards to the State Life [Insurance Corporation],” CEO of the Sehat Card Plus Dr Mohammad Riaz Tanoli told Dawn.

He said newly-elected Chief Minister Ali Amin Khan Gandapur and finance department bosses were informed about the due SCPpayment of Rs17 billion to the SLIC for the restoration of the health insurance programme.

Dr Tanoli said first, 85 per cent of the SCP services would resume, while the rest, including liver and renal transplants, implants of artificial limbs, and some surgical procedures, would be included in the programme after the cabinet’s approval.

Official says SLIC to get Rs5bn next week, Rs3bn every month afterwards

He said only dialysis, cancer, and emergency services had been available to those entitled to the SCP since Oct 19, 2023, taking the costs down from Rs3 billion a month to just Rs300m per month.

The CEO said the SCP was pioneered by the PTI’s government towards the end of 2015 with a population of three per cent population in four selected districts, but it was later extended to the entire population in phases.

“Until now, three million people have benefitted from the programme with women (54pc) outnumbering men (46pc). A total of 10.2m families, or 33.2m people, are registered for free treatment on the basis of their national identity cards registered in Khyber Pakhtunkhwa. Each family is eligible to avail itself of healthcare up to Rs10m per year,” he said.

Dr Tanoli said the government had so far spent Rs76.5bn on the health insurance programme covering most of the diseases requiring hospitalisation.

He said of the amount incurred on free healthcare, 60pc went to private hospitals and 40pc to public sector ones. On average, Rs28,500 is spent on a patient,” he said.

The CEO said after the first Ramazan, all secondary and selected tertiary care services under the SCP would resume at 119 empaneled hospitals in the province.

“We can later increase the number of empaneled hospitals, for which we will wait for the policy board’s meeting. It will be possible only after the notification of the health minister,” he said.

Dr Tanoli said until now, 159 kidney transplants were carried out under the programme with the cost of every procedure totalling around Rs1.4m.

He said a total of 64 people got liver transplants, with each surgery costing Rs5m. The CEO said 169,107 cardiac procedures, 530,041 dialysis, and 54,710 chemotherapy sessions were also performed under the SCP.

Meanwhile, the representatives of public sector hospitals hailed the government’s move to clear the SLIC’s dues for the resumption of the health insurance programme.

They said the Lady Reading Hospital was waiting for the SLIC to pay it Rs2bn for the treatment of those entitled to the SCP, while the Peshawar Institute of Cardiology also expected its unpaid amount of Rs1.5bn.

The Hayatabad Medical Complex and Khyber Teaching Hospital await payment of Rs600m and Rs500m each from the insurer. These four major hospitals have stopped services on the SCP due to non-payment of dues by the SLIC.

Sources said the SLIC didn’t make any payments to the hospitals in the last six months as it wasn’t receiving dues from the government.

They said not only big hospitals but the insurance company, too, had to clear the dues of district hospitals to ensure the continuation of their services.

“We are ready to start free healthcare after the assurance of regular payments by the new government. We hope that the programme will have smooth sailing like in the past when PTI ruled the province,” a hospital’s representative told Dawn.

He said non-payment of funds by the caretakers limited services under the health insurance scheme to emergency patients only.

Published in Dawn, March 3rd, 2024