Kathmandu. The government’s health insurance program’s liability to pay has reached Rs 16.45 billion. The Health Insurance Board, while releasing a status report through a press conference on Sunday (Chait 24), said that due to low income and high expenses, it is difficult to maintain financial imbalance, credibility of the board and financial sustainability.
Releasing the status report, Dr. Raghuraj Kafle, Executive Director of the board, said that the fund has limited sources of income and a deficit budget. “The Health Insurance Fund only receives the amount received from the insured and the amount received from the Government of Nepal. The board does not seem to be able to receive income from other sources,” he said. “As of mid-Falgun of the current fiscal year, the board had a total of Rs. 1 billion, but the amount to be paid is Rs. 16.45 billion. The gap between income and expenditure is constantly widening. In the current fiscal year, the board has approved a total budget of Rs. 26.59 billion, but the amount received seems to be only one-third of the approved budget.”
According to Kafle, the Health Insurance Fund has increasing liabilities and every year the fund has been paying Rs. 23.4 million for house rent. He said that crores of rupees are paid every year for salaries and allowances of working employees and registration support incentives, which is continuously increasing. “The amount paid to service providers is increasing by about two billion per month. Other administrative expenses also seem to be increasing regularly.
This is continuously increasing the gap between income and expenditure in the Health Insurance Fund,” Kafle said. “The deficit is increasing. According to the report received from the Office of the Auditor General, the board’s deficit is Rs 2.85 billion, 2.489 billion, 495 thousand, as of the last audit period of the fiscal year 2080/81. Kafle said that it is challenging to see 75 percent of the board’s annual internal income as surplus. It seems that more efforts need to be made towards eliminating surplus.”
He said that the average premium payment per family for health insurance is Rs 3,800, while the average payment for services received by each family from health insurance is Rs 8,350. Kafle said that there is equality in the rate of service recipients, but inequality in the total number. According to him, among the insured people in the provinces, in the fiscal year 2078/079, 42 percent of the people receiving health services in Koshi and Bagmati provinces, 36 percent in Gandaki, 34 percent in Lumbini, 26 percent in Madhesh, 34 percent in Karnali, and 25 percent in Sudurpaschim were insured. In the fiscal year 2080/81, the rate was 46 percent in Koshi, 44 percent in Bagmati and Gandaki, 39 percent in Lumbini, 29 percent in Madhesh, 54 percent in Karnali, and 40 percent in Sudurpaschim.
Kafl said that since participation in insurance is very low in economically and socially backward provinces, the number of people receiving services there is also very low and similarly, a majority of the citizens of those provinces have yet to be covered by health insurance. According to him, the health insurance program has currently expanded to 749 local levels in 77 districts.
“A total of 89,52,135 people have been enrolled in health insurance since the program was implemented. As of mid-Falgun of the fiscal year 2081/82, the number of active insured persons is 57,53,817, which is 20 percent of the total population,” he said, “Out of which 43,20,709 are general active insured persons, or 75 percent of the total insured persons, and 14,51,108 are active targeted insured persons, or 25 percent. Analyzing the number of active insured persons, it is clear that more efforts are still needed to cover the majority, or 80 percent, of the citizens.”
प्रतिक्रिया दिनुहोस्