While the PML-N government seems rather fond of launching schemes with much fanfare, its ability to follow through with them effectively, remains suspect. The multibillion-rupee health insurance plan launched four months ago by the prime minister seems to be failing already because of poor planning. The insurance scheme, worth Rs9.1 billion, aimed to provide cashless health services to the poorest. While the three-year scheme was meant to offer free healthcare to people in 23 districts of the country in its first phase, it has now emerged that its intended beneficiaries have still not been identified. Besides having no target population, there also appears to be no plan on how health services are to be provided. Even if people receive their health insurance cards, questions regarding where they will be able to use these to avail medical services, remain unanswered. In a briefing to a National Assembly Standing Committee, the programme director of the scheme said the plan cannot be launched in districts such as Bahawalnagar in Punjab, and Chaghi in Balochistan due to lack of health infrastructure in these regions. This begs the question as to whether there was any planning done in advance of launching the programme; whether anyone realised that basic health infrastructure needed to be put in place first?
The NA panel was also informed that many tehsil and district- level hospitals have neither the financial autonomy nor the infrastructure available to provide complete health services, rendering the health insurance cards useless in such areas. There is also very poor coordination between the centre and the provinces, with Khyber-Pakhtunkhwa and Sindh having done little to implement the insurance plan. People in this country die on hospital beds, as there is a lack of the most basic medical facilities. The deaths of infants in Sargodha is still fresh in minds, when at least 26 newborns died at the District Headquarters Hospital, because there were not enough incubators, oxygen or doctors to save their lives. In such a backdrop, the health insurance scheme could have contributed significantly in saving precious lives, however, the lack of basic homework has caused serious setbacks. The government must realise that insurance cards alone cannot help resolve the deep-seated health problems we face. It needs to start spending its resources on first providing proper health infrastructure.
Published in The Express Tribune, April 8th, 2016.