Building a safety net

Pakistan seems to have begun to build the rudiments of a welfare state. It is unlikely to match the comprehensive cover that is found in many Western states but there may eventually be a degree of support to many of the poorest in society. The blueprint for most modern welfare states was provided by the Beveridge Report of December 1942 that identified five “great evils” in society of the time — squalor, ignorance, want, idleness and disease. It was the foundation on which the British eventually built the post-war National Health Service, which provided free universal medical care. There is no equivalent in Pakistan of the Beveridge Report, but there seems to be growing awareness within governments that the provision of support for the neediest is an essential part of the social compact. Thus we welcome the proposal of the Punjab government to provide health cover for almost 280,000 poor families in four districts in 2015.

The health department is going to register a company that will seek proposals from insurance companies for the provision of basic health care to the poor. The project costing Rs4 billion is to be launched in Layyah, Rajanpur, Hafizabad and Chakwal in March 2015. Pakistan already has the Benazir Income Support Programme (BISP), which has been continued by the PML-N government. Adding basic health cover up to a value of Rs35,000 will build on the BISP and there is an obvious need to provide similar coverage in all other provinces. Poverty is increasing, as is food insecurity. Natural disasters linked to climate change are now an annual occurrence. Successive governments need to make universal basic provision for the most needy. In the West, such services are funded by mandatory individual contributions — everybody pays no matter their social status, with national insurance being the yarn that gives substance to social safety nets. The poorest in Pakistan can never pay — but taxation of earned income may provide the revenue to protect the most vulnerable.

Published in The Express Tribune, December 13^th,  2014.

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