Good but not enough

The PML-N has attempted to answer criticism that the party does not pay any attention to the social welfare of the country’s poorest citizens. Prime Minister Nawaz Sharif has announced the launch of the National Health Programme. The programme will issue health cards to citizens below the poverty line qualifying them for receiving financial support to subsidise their hospital bills. The promise is that any card-holder will be able to access treatment in both public and private hospitals without delay. Card-holders will get Rs50,000 for common illnesses, Rs300,000 for serious illnesses which could be increased to Rs600,000 in case of prolonged illness. The initial target is to register 1.2 million families on health insurance cards. While the prime minister insisted that the cards would go towards fulfilling the PML-N’s promise of a welfare state, the cards act much like the Benazir Income Support Programme, offering some reprieve without addressing any of the structural issues that plague the health system in the country. The money allocated for the programme is Rs9 billion which, compared with the Rs120 billion for the Lahore Orange Line, should be an indication of where this apparently national health insurance stands. Sindh and Khyber Pakhtunkhwa have not signed onto the programme and its initial target zone is only 15 districts in the country.

One more question we need to be asking is why the government would choose to provide health insurance instead of upgrading the public healthcare system. With healthcare no longer a federal subject, the health insurance scheme for the poor is a decent enough intervention on its own terms. However, the task of the government is to look at the overall picture of healthcare in Pakistan. Pakistan spends only around $9 per citizen on healthcare against the recommended international standard of $60 per citizen. In terms of GDP spending, health amounts to only 0.5 percent of GDP. The result is that – despite a

relatively developed network of public hospitals that provide cheap treatment for the poor – private healthcare of varying qualities has mushroomed in the face of continuing government neglect. The state of public-sector facilities can be seen in the lack of machines, beds, medicines and even doctors. In such a context, would it not be better for the government to prioritise infrastructural spending in healthcare? The health insurance programme is a step in the right direction, but it would be far more beneficial if the government were to address healthcare issues in a holistic manner.