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Qaumi Sahulat Card: Game Changer for Ordinary Pakistani

Over 150 million Pakistanis will benefit shortly from the PTI government's Sehat Sahulat Program. People living in Punjab, Khyber Pakhtunkhwa, Azad Kashmir, Islamabad, and Gilgit-Baltistan can now benefit from the health insurance scheme, ensuring that each family receives health services worth up to Rs1 million per year. A game-changer in the life of the ordinary man. Currently, over 700 public and private hospitals are participating in the Program, which is expected to increase to 1000 by March 2022.

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As a broad concept, universal health coverage (UHC) primarily calls for access to quality health for every citizen without pushing them into financial hardships. Developed, as well as developing countries all over the world, have struggled with providing UHC to their citizens. Recently, while launching the Naya Pakistan Qaumi Sehat Card program to Islamabad, Prime Minister Imran Khan mentioned how universal health coverage is an essential plank that will help transform Pakistan into a welfare state.

Research from Pakistan and other developing countries systematically shows that a significant proportion of the population faces catastrophic health payment issues. These create a substantial financial burden on the individual or families and often force them into chronic poverty and reduce their long-term opportunities in life. A recent Oxfam report revealed that household surveys conducted in May 2020 showed that close to 50 percent of households in Pakistan could not receive medical attention due to a lack of money.

Talha Hashmi, a beneficiary of the Sehat Insaf Card in Punjab, spoke to GVS and expressed his gratitude and thanked the government saying that without the Sehat card, he would not have been able to afford his wife’s nephrectomy treatment. The couple had approached the University of Lahore Teaching Hospital that helped them apply for the card and guided them through the process.

Read more: Sehat Insaaf Card for around 6 million families in Punjab

The PTI government’s Qaumi Sehat card will provide free medical in-hospital treatment to all permanent residents living in Punjab (phased in – up to 36 districts by March 2022), Khyber Pakhtunkhwa, Azad Kashmir, Islamabad, Gilgit-Baltistan, and District Tharparker. The individual’s CNIC card will act as their health card. Very soon every citizen of Pakistan will have full universal health coverage, a feat that is unknown even in developed countries such as the United States.

Under the Sehat Sahulat Program, each family will receive health coverage of Rs. 1 million– it is estimated that the government is paying a premium of around Rs. 2,800 to the insurance company to insure each person. It includes treatments such as open-heart surgeries, stents, cancer management, neurosurgical procedures, burn management, dialysis, intensive care, deliveries, C-sections, and other medical and surgical procedures.

“The overall experience was good. We faced no difficulties,” Talha Hashmi said. “It is a great initiative for the poor people. Without it, I would have not been able to afford the surgery,” he further added.

Currently, under the 18th Amendment passed on April 8, 2010, the federal ministry of health was abolished, and health as a subject was delegated to the provincial level. This has created huge coordination issues between the federal and provincial governments on health care initiatives, including the implementation of the Sehat Sahulat Program (SSP). The Sindh provincial government has shown resistance to implementing the health care program given its initiation was by the PTI government. However, the federal government has unilaterally extended the program district Tharparkar, one of Sindh’s poorest districts.

The Sehat Sahulat Program and UHC in KP

Prime Minister Imran Khan has long been a champion of taking initiatives to provide quality healthcare in Pakistan. Before politics, he built the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), a cancer centre to make cancer treatment accessible in Pakistan.

The vision of the Shaukat Khanum centre states “To act as a model institution to alleviate the suffering of patients with cancer through the application of modern methods of curative and palliative therapy irrespective of their ability to pay, the education of health care professionals and the public and perform research into the causes and treatment of cancer.”

When the PTI provincial government launched SSP in Khyber Pakhtunkhwa in 2015, it quickly showed historical results in the province where it was extended in phases. The first phase of the Program was launched in 2015, covering three percent of the population (100,000 families in four districts) of KP. In its second phase in 2016, the Program was extended to 51 percent of the population (1,791,930 families in all KP districts). The third phase of the Program started in 2017, covering 64 percent of the population (3,200,000 families). Finally, in the fourth phase, all families in KP were covered by the beginning of 2021. The provincial government is believed to be currently paying a fixed premium, around Rs. 2,000, per eligible family (average family assumed to be 5.7 people) to State Life Insurance Company, which in turn manages members’ healthcare expenditure. The current utilization percentage is between 3 – 8 percent, which is the average uptake of such services worldwide.

Read more: Islamabad police officials will get health cards and houses: PM Imran

PTI provincial government implemented the Program despite budgetary constraints. The SSPs’ success in KP and the Prime Minister’s vision of universal health coverage in Pakistan prompted the government to further extend healthcare equity in the province. This successful project implementation in KP set the example for all developing healthcare initiatives in other provinces, especially Punjab.

Since the Qaumi Sehat Card covers all family members, 33-year-old Sonia Amjed, living in Lahore, was able to get general surgery for her brother at Akhtar Saeed Hospital completely free of charge. “Even the medicines were provided free of cost,” the patient said while appreciating the program.

In Punjab, the Program is expected to be completed in three phases. It is to be expanded in all 36 districts of Punjab in its first phase, with Sehat Insaf Cards being distributed to these families. This is expected to cover 30 million families and 115 million people by March 2022.

The SSP is an ambitious program for Pakistan enabling the poor to receive good quality care never available to them earlier. If it is sustainable it will produce a competitive environment for public and private hospitals, motivating the public sector to keep up with their quality and improve their health services to compete with private-sector hospitals.

Read more: PM orders setting up special units to ensure provision of health card in Punjab, KP