ISLAMABAD: The government has cleared, in principle, Prime Minister’s laptop scheme at an estimated cost of Rs21 billion but deferred approval of PM’s National Health Insurance Programme for the poorest population after finding it in violation of the 18th Amendment in the constitution.
The Central Development Working Party (CDWP) on Wednesday recommended implementation of phase-II of the PM’s laptop scheme for the final decision of Executive Committee of National Economic Council (Ecnec). The CDWP has the mandate to approve up to Rs3 billion projects and the mega projects falling above this threshold can only be sanctioned by the ECNEC.
The CDWP had objections over the cost of the laptop scheme as the Rs20.9 billion estimates were worked out on the basis of Rs105 to a dollar exchange rate, which was far higher than the prevailing value against the US dollar. The higher dollar valuation resulted into Rs474 million over estimation on the basis of $157.8 million foreign exchange component.
The second phase will be implemented in four years and will be completed in 2018, the year when general elections will be held in the country. The value of a single laptop has been assessed at Rs51,540. Under phase one of the scheme, as many as 93,975 laptops have been delivered in 86 universities and degree awarding institutes.
After finding flaws in the project planning and its execution, the CDWP, which was chaired by Minister for Planning and Development, Ahsan Iqbal, deferred the clearance of PM’s National Health Insurance Programme.
National Health Insurance Programme
The premier has envisioned the three-year Rs9.2 billion scheme to ensure 100% health insurance for the poorest segments of the society. The scheme promises health coverage for 60% of the poorest families or roughly for 100 million people, according to project documents.
Out of Rs9.2 billion, Rs8.8 billion have been earmarked for payment of the premium in phase one but the basis of the premium cost estimates were missing from the project documents.
The Planning Commission has already reduced the scope of the project to lower the cost from originally proposed Rs45 billion to Rs9.2 billion. The government has proposed Rs2, 000 per family annual premium for daycare and maternity services with addition of Rs500 per family for priority treatment. The priority treatment will include cardio regular diseases, diabetes, burns, road traffic accidents, rental and other chronic diseases.
The proposal also includes Rs50,000 per family annual premium on floating basis, which should come from provincial and federal development budgets for tertiary care. Another Rs250,000 per family premium is also proposed for federal hospitalisation against identified treatment protocols. The federal government has proposed to indentify targeted people by using the database of National Database Registration Authority.
There is lack of quality healthcare services along with the need of healthcare for poor segment of the society.
However, the CDWP had to defer the approval after a committee constituted to scrutinise the project documents found that the project fell in the area, which was a domain of the provinces. There were also no firm financing commitments from the Finance Ministry.
A CDWP-constituted committee has sought the resolution of Council of Common Interests for seeking firm financing commitments from the provinces to fund part of the health insurance scheme. There were also other legal hindrances in implementation of the scheme as the health sector has been devolved to the provinces, according to the project documents.
The Planning Ministry experts have also highlighted duplication of activities as the governments of Punjab, Khyber-Pakhtunkhwa and Gilgit Baltistan have already launched health insurance schemes.
Published in The Express Tribune, March 5th, 2015.