सिंहदरबार संवाददाता
Kathmandu. The public statement made by Health and Population Minister Pradeep Poudel a few days ago about health insurance has now become controversial.
At a program of the Nepal Pharmaceutical Wholesalers Federation held in Kathmandu last week, lawmakers also raised their voices in the House, saying that the statement he made raised questions about the future of health insurance.
According to the Health Insurance Board, health insurance, which started in Chaitra, 2072, has now reached 77 districts. There is a suspicion that the program, which is being provided to the insured by 484 health institutions, including 48 private ones, with 8.9 million people affiliated to the health insurance across the country, will not be closed if the leader of the Talukdar Ministry makes a controversial statement about this program.
In this context, an edited excerpt of a conversation with Health Minister Pradeep Poudel
After assuming office, you had said that you would make the health insurance program effective and increase the amount, but why have you suddenly backed down now?
## When speaking in detail at a program, the middle part of the speech has now come out, especially that only health insurance can make Nepal’s health sector effective. A person like me who believes that effective, simple, cheap and free treatment can be provided to citizens for those who need it cannot talk about abolishing health insurance.
Health insurance cannot be run in this way, it needs to be managed. Its funds need to be secured. It is necessary to remove all the irregularities that exist here. Health insurance should be able to create a situation where many citizens contribute. By arranging for many citizens to contribute, and for those who cannot contribute, the state will pay the premium free of charge, and now, instead of spending 100 rupees from the citizen’s pocket, 55 rupees are spent on treatment.
Now we should create a situation where citizens can be treated for 20 rupees through insurance. That is why we are not trying to end insurance, but to manage insurance. We are trying to make arrangements for treatment only through insurance. We have formed a committee to manage this.
That committee has already submitted its report. The implementation report has also been prepared for implementation and it is moving forward very quickly to strengthen its management aspect. Therefore, there is confusion outside due to the topic spoken in one context somewhere, which is very wrong. The socialism in health that we are trying to bring can only be achieved through health insurance.
How do you make the health insurance fund safe?
Answer: Health insurance should be organized and made safe. All citizens should be included in the insurance. Whoever can contribute to the fund should do so from whatever means. For example, those who earn a salary can contribute from a small part of their salary, and those who pay taxes can contribute from a very small part of their tax.
The state should make arrangements to give a small percentage of its income to the insurance fund from whatever side it can earn. Health insurance programs should be operated through a single-door system. The entire budget of the health sector of the Social Security Fund, Provident Fund, and Citizen Investment Fund should be taken to the Health Insurance Fund.
Health insurance programs should now be operated through a single-door system, not in a scattered manner. Whatever health facilities the state has provided, they should be taken to the insurance fund. Now, arrangements should be made to require insurance to obtain a national identity card and passport.
All citizens should be required to join insurance, secure the insurance fund, create a regular income situation, and the state should also contribute as much as it can.
How exactly can we make it possible to contribute?
Salary payers should be asked to contribute from 1.5 percent of their salary so that they do not have to pay premiums, tax payers should be asked to contribute from 1.5 percent of their tax so that they do not have to pay premiums, and those who do not receive salaries and do not pay taxes should be made to contribute by paying premiums.
Those who cannot do all three of these should be added to the insurance by paying premiums.
Is there a situation of fake claims now?
Answer: Yes, there is a situation of fake claims now. The situation of saying that treatment was done without treatment, that situation of fake claims should be completely ended.
A strict law should be brought and it should be implemented. The payment should not be increased by more than 10 percent. It is also necessary to organize this. The management aspect of this should be improved and a situation should be created where everyone can get treatment through insurance.
Why hasn’t insurance been paid since Shrawan?
The arrears related to last year’s insurance are about 16 billion. Which is not even in the title of the current budget. The total amount allocated for insurance in the title of the current budget is 7.5 billion. If we calculate this for the entire 12 months and the 16 billion of the previous year, it will go above 35 billion.
Therefore, it is bound to be in trouble because there is no safe fund. After I became the Minister of Health, this year’s 7.5 billion budget has been paid. There are still 5 months left in this fiscal year. When this year’s money is paid, the full payment has not been made until Ashar 2081.
The entire amount due since Ashar has been due. Since Ashar, there has been a situation where private hospitals have also been added. The amount that was seen last year has been seen more than double this year. Therefore, insurance cannot be managed without creating a safe fund.
How will that amount be paid now?
Answer: The arrears that the state has promised to pay cannot be said to have been paid. The fake claims that exist must be identified and removed.
The remaining amount after removing the fake claims must be paid. Only one hospital has an arrears of 600 million. There is no situation where the hospital should continue to provide treatment without paying. The government cannot pay without reaching a conclusion about the current fake claims, but we are preparing to pay 50-60 percent of the amount very quickly.
Are you preparing to postpone the program to find out ‘fake claims’?
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## Answer: Fake claims need to be detected. Crores of rupees are being added every day. So, the question is whether to postpone it for some time to organize it.
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## That postponement does not mean that it will be done everywhere, there is an ongoing discussion on whether to postpone only some parties. The context of my statement is that health insurance has not been organized, there is a challenge to organize it and create a safe fund. We will do both these things.
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