The good doctor

Asher Hasan talks a lot. He’s a compelling speaker and he knows it. When we meet at his large, quiet home, his enthusiasm for his work and his life is unmistakable.

Hasan is one of the three people behind Naya Jeevan, an organisation that encourages MNCs, small and medium enterprises, schools and other entities to share the cost of their low-income employees’ monthly health insurance payments, thereby subsidising healthcare for a deserving family.

Naya Jeevan was conceived in 2007 by Hasan and his partners Irum Musharraf and Saad Tabani.

“Saad had the IT expertise. Irum was the risk-management expert. I provided the vision,” he says.

Hasan, who looks younger than his 38 years, was inspired by the safety net health insurance provides in the US and wanted to “get informal workers into the loop — waiters, maids, drivers... at least 40 million people.”

The scheme is underwritten by prominent insurance companies Allianz EFU, IGI Insurance Limited and Asia Care. Each beneficiary holds an insurance card that allows him or her access to a wide network of hospitals affiliated with these companies.In this way, Naya Jeevan aims to protect low-income families from drowning in debt when they are faced with a catastrophic healthcare crisis. As Hasan says, a single event like a stroke or a cardiac arrest can set a low-income family back for generations, trapping them in a vicious cycle of poverty.

Hasan spent his younger years shuttling between the United Kingdom and Pakistan, where his grandparents lived. His family settled in Pakistan in 1983 following the death of his father. The tragedy was followed by a new challenge — Hasan’s mother, who had been left in charge of the family’s finances, suddenly had a nervous breakdown and was rendered incapable of looking after Hasan and his three sisters.

“We went from being very affluent to just getting by,” he says. “There was this three and a half year period where I was surrounded by rich kids, but couldn’t participate in their activities. It was like being an outsider, which gave me a lot of empathy.”

“But I feel like that was destined to happen,” he adds. “I feel I really had to do something to address this inequality.”

His notion of revamping Pakistan’s healthcare system led him to quit a lucrative job in the bio-tech industry in the US and relocate to Pakistan, where he has been living for a year now. He says people thought his eagerness to give up life in the US and move back to Pakistan for a dream was madness.

“Oh yeah, I get a lot of resistance from my family. Some of my fiercest critics are my siblings,” he laughs. “They either think I’ve become a raving lunatic or experiencing delusions of Gandhi-ism. The thought process of most people who resist the idea, or my choice, is emblematic of the very problem that Pakistan is faced with,” he says. “Skilled people who leave the country and are educated abroad either forget their responsibilities to this country, or become self-absorbed.”

In turn, Hasan doesn’t hide his disdain for people who live a “cushy lifestyle”, despite living quite comfortably himself in Karachi. When asked when he manages this in spite of running a not-for-profit social enterprise that relies heavily on donations to operate he is amused by the question. Hasan explains, “I was fortunate enough to have done fairly well in my career in the US. I was able to live off my savings for the last three years. Now we are better off, we have decent funding and can pay modest salaries.”

Hasan says Naya Jeevan’s staff, which has grown from three to 18 people in the last few years, is compensated very well, because “we want to tell people they can do well for themselves while doing good for others.”

Though conceived in 2007, Naya Jeevan became fully operational in 2009, after receiving support from the Draper Richards Foundation and getting insurance underwriters on board.

Although the scheme’s premise is sound, Naya Jeevan currently has only 2,000 card-carrying beneficiaries, with another  7,000 being processed, and Hasan admits that getting people to adopt a new system is challenging.

Irum Musharraf, Naya Jeevan’s co-founder and chief operating officer is based in the US, and agrees that getting companies to “cut the cheque” is a challenge.

Musharraf says most people in Pakistan, especially low-income employees, are unfamiliar with the concept of insurance. To this end, Musharraf says Naya Jeevan also conducts workshops with a corporation’s low-income employees to make them aware of their rights and privileges as insurance holders.

However, Musharraf is optimistic about the future, as is Hasan. The team is launching several new schemes soon, including a child-to child scheme that allows affluent children to share in the cost of a low-income peer’s insurance, and Naya Jeevan’s founders say the initial struggle to get off the ground was worth it.

“In this age, you can dream the impossible and make it happen,” Musharraf says.

Hasan believes that he has identified several reasons for why people are resistant to the concept. He cites inertia and selfishness as factors, and adds that most people are only interested in social causes that are in vogue.  “It’s unfortunate that it has to be done this way,” Hasan says. “But we have to identify a trendsetter in each sector, get them on board, and lure competitors on board through them.”

One such trendsetter is Espresso, the successful chain of coffee houses owned and run by Kamil Aziz Khan and his partners.

Khan admits that it took him a while to sign on to Naya Jeevan’s scheme, mainly because of bureaucratic delays.

He also says it was Hasan’s persistence that motivated him to adopt the insurance program in the end: “He used to call me all the time, asking why we hadn’t signed on. If he hadn’t been that persistent, I don’t know if we would have made the commitment.”

Now that Espresso’s employees are covered by Naya Jeevan’s scheme, however, everyone can see the benefits.

Khan says one of his employee’s wives recently claimed insurance cover to treat kidney stones, a procedure which costs well over Rs100,000.

If the employee hadn’t been insured, Khan says, he would have taken a loan to cover the medical cost. “And it would be difficult for them to pay off the loan,” Khan adds. “They would end up in a cycle of debt.”

“I would encourage people to not just focus on material acquisition,” adds Hasan.  “If I were to compare my life today with my life a few years ago, when I was making much more money, I can definitely say I’m happier now. I feel I belong here, and I feel I’m making a difference.”

Published in The Express Tribune, August 22^nd, 2010.