Health is the most vulnerable sector today. With masses becoming more health-conscious and clinically aware of the rising health costs, the introduction of the national health card better known as the ‘Qaumi Sehat Card’ is nothing short of revolutionary. Still, some may call it an eventual failure.
With PKR 1million free coverage for each family and treatment in the best hospitals might be a good unique USP-unique selling proposition for the government, the fact that it is a game-changer for the country is yet to be seen.
By March next month, approximately 180 million people will have access to health care as per media and government sources. In modern society, ease of access is key. Is it really so simple to just text your national identity card number and get confirmation of health care coverage? No start-up issues? No teething problems or service delivery failures?
Let us analyze this
The health care scheme is being launched in Punjab, KPK, Gilgit Baltistan, Azad Kashmir and the Federal Capital at the approximate cost of PKR 450 bn. On a simple calculation, having the government construct more hospitals per province will give a bigger benefit to the nation. In KPK for example, the health card scheme incurred a cost of 12 to 15 billion PKR, since inception in 2016. Based on the same premise, a medium-sized 300 -400 bed hospital can be constructed in less than 5 bn, which may include all tertiary care facilities like ICU, CCU, ENT, pathology labs, general surgery, ophthalmology departments, pediatrics facilities, medical facilities and general surgery, amongst other units. If we added a minimum construction time of under 365 days and with the better deployment of government resources on construction, a better end result may have been achieved.
The government could have constructed 36-40 small hospitals within the same cost while saving surplus funds of approximately 85-90 billion in reserve funds to invest in strengthening the infrastructure challenges, leading to more efficient patient-care facilities. By a conservative estimate, an average 60-bed small hospital may cost anywhere between PKR 136 million to 140 million, including working capital costs.
Public service hospitals would have been a life-long gift to the nation
The even spread of the hospitals would have further led to equitable service delivery access to patients with better IPCs (infection prevention controls), better waste management and eventually easier accessibility to patients traveling long distances to avail health care as a priority option. By a conservative estimate, an average 60-bed small hospital may cost anywhere between PKR 136 million to 140 million, including working capital costs. If the government had taken up this initiative to construct these hospitals instead of relying on the private sector, perhaps it would have been a great way-forward strategy.
In principle, it is a fact that a major benefit of this health care facility is health care access to all. But here is the big question? Who will actually benefit from health care coverage? Many citizens despite being medically insured by their employer, like the high earners from the corporate sector or people from the armed forces already entitled to health benefits or even the ultra-rich able to afford private health care; may seek this facility simply on basis of power and entitlement.
Read more: PM Khan to launch Sehat Card for Faisalabad
On one hand, the average poor family has little or no access to private health care and will go to the government hospital to avail the health care benefit of hospitalization, as e coverage of PKR 1 million does not cover OPD, diagnostic tests or medicine purchases unless you are hospitalized. On the other hand, many high-end citizens may even end up opting for treatment through private hospitals, simply on the basis of affordability.
Another question arises
Do government hospitals have the infrastructure for this kind of facilitation?
Private hospitals in most big cities do not cater to the mass majority of people across small cities and that can become a problem in the future. Here, the regulatory health authorities may then have to be engaged to conduct transparent inspections to pre-select or approve a list of hospitals, fully qualified to pass on this service benefit to the end-customer/ patient/user. The success of one province can then be replicated in others.
The key objective is the ease of access of services across to the patients, whether it is a small clinic, x-ray lab, pharmacy, or big hospital. Here, the availability of doctors in rural hospitals is another problem to be addressed. Unless a qualified doctor is available for operative care in hospitals in far-out areas, the issue is illegal health care practitioners will continue to arise in the future. Expert qualified doctors must be hired and placed for a minimum of 2 years in one particular area for that particular hospital, based on their domicile, equipped with qualified nursing staff, technicians and pathologists and other vital staff necessary to monitor that efficient care is being provided to patients hospitalized.
Is this scheme a truly successful venture? Only time will tell
In the last two years, the state of health care in the nation has deteriorated due to illegal health care practitioners operating in place real qualified doctors and the problem is there at the provincial government levels to ensure legitimate doctors are placed to ensure duties under a proper monitoring and evaluation mechanism to review their performances. This will greatly reduce the threat of malpractice within the health care industry if take this matter up honestly. Budget allocation to the health sector must also be increased as it has never been done in the past.
Summing up, the above recommendations can be further reviewed and revised for improvement by the policy-makers as the need of the hour and the issue of budget allocation must be tabled in the parliament and implemented at the earliest possible to make this scheme the most successful venture in the history of Pakistan and a true ‘game changer’ for the health-care industry.
Zeeshan Shah is a writer and researcher and tweets @zeeshan82445998. The views expressed in the article are the author’s own and do not necessarily reflect the editorial policy of Global Village Space.